US12390266B2 - End tool of surgical instrument and electrocauterization surgical instrument comprising same - Google Patents

Abstract

Provided is a surgical instrument for electrocautery, and in particular, a surgical instrument for electrocautery installed on a robot arm or manually operable in order to be used in laparoscopic surgery or other various surgeries.

Description

CROSS-REFERENCE TO RELATED APPLICATION(S)

The instant application is a continuation application of international patent application No. PCT/KR2023/007038, filed on May 23, 2023, which claims priority to Korean Patent Application No. 10-2022-0063142, filed on May 23, 2022, and Korean Patent Application No. 10-2023-0028807, filed on Mar. 3, 2023, with the Korean Intellectual Property Office, the disclosures of which are incorporated herein in their entirety by reference.

TECHNICAL FIELD

One or more embodiments of the present disclosure relate to an end tool of a surgical instrument and a surgical instrument for electrocautery including the same, and in particular, to an end tool of a surgical instrument and a surgical instrument for electrocautery including the end tool that is capable of rotating in two or more directions and intuitively matching a movement of a manipulation portion, wherein the surgical instrument may be installed on a robot arm or manually operable in order to be used in laparoscopic surgery or other various surgeries.

BACKGROUND ART

Surgical operations in many cases require cutting and joining of body tissues including organs, muscular tissues, connective tissues, and blood vessels. Over the centuries, sharp blades and sutures have been used for cutting and joining. However, bleeding occurs when cutting body tissues, in particular, relatively highly vascularized tissue during surgical operation. Therefore, doctors require surgical instruments and methods to slow or reduce bleeding during surgical operations.

Recently, it has become possible to use an electric surgical instrument that uses electrical energy to perform certain surgical tasks. For example, regarding surgical instruments such as graspers, scissors, tweezers, blades, needles, and hooks, electric surgical instruments including one or more electrodes formed to receive electric energy have been developed. Electrical energy supplied through the electrodes may be used to coagulate, bond, or cut the patient's body tissues. In particular, when electrical energy is used, amputation and hemostasis may be performed at the same time.

Electric surgical instruments are typically classified into two types: monopolar and bipolar. In a monopolar electric surgical instrument, electrical energy of a specific polarity is supplied to one or more electrodes of the instrument. And electricity of different polarity is electrically connected to the patient. In a bipolar electric surgical instrument, one or more electrodes are electrically connected to a first polarity electrical energy source, and one or more electrodes are electrically connected to a second polarity electrical energy source opposite to the first polarity.

The above-mentioned background art is technical information possessed by the inventor for the derivation of the present disclosure or acquired during the derivation of the present disclosure, and cannot necessarily be said to be a known technique disclosed to the general public prior to the filing of the present disclosure.

DESCRIPTION OF EMBODIMENTSTechnical Problem

The present disclosure is directed to providing a surgical instrument for electrocautery including an end tool that is capable of rotating in two or more directions, and moving to intuitively match a movement of a manipulation portion, in a manually operable surgical instrument for electrocautery that is installed on a robot arm or manually operable for use in laparoscopic surgery or other various surgeries.

Solution to ProblemSecond Embodiment of Surgical Instrument for Electrocautery-Forming X-Shaped Structure of First and Second Jaws

FIG.41 is a perspective view illustrating a surgical instrument for electrocautery according to a second embodiment of the present disclosure.FIGS.42 to47 are views illustrating an end tool of the surgical instrument for electrocautery ofFIG.41.

Referring toFIG.41, an electric cauterization surgical instrument10 according to the second embodiment of the present disclosure includes an end tool700, a manipulation portion200, a power transmission portion300, and a connection portion400.

The electric cauterization surgical instrument10 according to the second embodiment of the present disclosure is different from the electric cauterization surgical instrument10 according to the first embodiment in that the end tool700 has a different configuration, and thus the configuration of the end tool700 will be described in detail below.

The end tool700 is formed on the other end portion of the connection portion400, and performs necessary motions for surgery by being inserted into a surgical site. In an example of the end tool700 described above, as illustrated inFIG.41, a pair of jaws703 for performing a grip motion may be used.

However, the concept of the present disclosure is not limited thereto, and various devices for performing surgery may be used as the end tool700. For example, a configuration of a cantilever cautery may also be used as the end tool700. The end tool700 is connected to the manipulation portion200 by the power transmission portion300, and receives a driving force of the manipulation portion200 through the power transmission portion300 to perform a motion necessary for surgery, such as gripping, cutting, suturing, or the like.

Here, the end tool700 of the electric cauterization surgical instrument10 according to the second embodiment of the present disclosure is formed to be rotatable in at least one direction, and for example, the end tool700 may be formed to perform a pitch motion around a Y-axis ofFIG.41 and simultaneously perform a yaw motion and an actuation motion around a Z-axis ofFIG.41.

Referring toFIGS.42 to47,55, and56, the end tool700 of the electric cauterization surgical instrument10 according to the second embodiment of the present disclosure includes a first electrode751, a second electrode752, a pitch hub750, an end tool hub760, a plurality of rotation shafts741,743, and744, and the like that are the same as those of the first embodiment in configuration and effect, and is different in that a jaw rotation shaft701e, a tube through hole701f, a jaw pulley coupling hole701d, and a movable coupling hole701care formed in a first jaw701, and a shaft pass-through portion702ethrough which the rotation shaft701e, which is a jaw rotation shaft formed in the first jaw701, is able to pass, a movable coupling hole702c, and a hole702d, which is a jaw pulley coupling hole, are formed in a second jaw702 that faces and is connectable to the first jaw701.

FIG.48 is a perspective view illustrating the end tool hub of the surgical instrument for electrocautery ofFIG.41.FIGS.49 and50 are cut-away perspective views of the end tool hub ofFIG.48.FIGS.51 and52 are perspective views illustrating the end tool hub ofFIG.48.FIG.53 is a side view illustrating the end tool hub ofFIG.48 and a guide tube.FIG.54 is a plan view illustrating the end tool hub ofFIG.48 and the guide tube.

Referring toFIGS.48 to54, the end tool hub760 provided in the end tool700 of the electric cauterization surgical instrument10 ofFIG.41 has a predetermined radius of curvature on an inner circumferential surface thereof for gentle curved movement of the guide tube670, and may include a yaw round portion767 and a pitch round portion766 formed in a curved shape.

In addition, a yaw slit765 passing through the end tool hub760 may be formed on a plane perpendicular to a first rotation shaft741 to allow a guide tube770, which is configured to guide a movement path of a blade775 and the blade wire307 connected to the blade775, to stably move through the end tool hub760.

In addition, a pitch slit764, which is a separation space, may be formed between a first pitch pulley portion763aand a second pitch pulley portion763bfacing each other so that the guide tube670 may pass therethrough, thereby allowing the guide tube770 to stably move through the pitch slit764.

Referring toFIG.51, in addition to the yaw slit765 formed in the end tool hub760, the yaw rotation shaft741 may be divided into two parts and provided as a pair, and the guide tube670 may move through a space formed between the divided pair of yaw rotation shafts741.

Referring toFIGS.51 to54, the end tool hub760 of the surgical instrument for electrocautery according to the second embodiment has the same configuration as the end tool hub660 of the surgical instrument for electrocautery according to the first embodiment, and thus a detailed description thereof will be omitted in the overlapping range.

FIG.55 is a perspective view illustrating the first jaw of the end tool of the surgical instrument for electrocautery ofFIG.41.FIG.56 is a perspective view illustrating the second jaw of the end tool of the surgical instrument for electrocautery ofFIG.41.

Referring toFIG.55, the first jaw701 of the end tool700 of the surgical instrument for electrocautery ofFIG.41 may include the jaw rotation shaft701e, which has the tube through hole701fformed therein and is formed to protrude, the movable coupling hole701c, and the jaw pulley coupling hole701d.

The first jaw701 is formed entirely in an elongated bar shape, a path through which the blade775 is movable is formed in the first jaw701 at a distal end side (left side based onFIG.55), and a pulley711, which is a first jaw pulley, is coupled to the first jaw701 at a proximal end side (right side based onFIG.55) and formed to be rotatable around the rotation shaft741.

Referring toFIG.55, the movable coupling hole701cand the jaw pulley coupling hole701dmay be formed in the first jaw701 at the proximal end side. Here, the movable coupling hole701cmay be formed to have a predetermined curvature, and may be formed in an approximately elliptical shape.

A shaft coupling portion711aformed on the first jaw pulley711 may be fitted into the movable coupling hole701cformed in the first jaw701. Here, a short radius of the movable coupling hole701cmay be formed to be substantially the same as or slightly greater than a radius of the shaft coupling portion711a.

Referring toFIG.55, a long radius of the movable coupling hole701cmay be formed to be greater than the radius of the shaft coupling portion711a. Thus, a path may be formed so that the shaft coupling portion711ais movable therethrough to a certain degree in the movable coupling hole701cin a state in which the shaft coupling portion711aof the pulley711 is fitted into the movable coupling hole701cof the first jaw701, This will be described in detail later.

Referring toFIG.55, the jaw pulley coupling hole701dformed in the first jaw701 is formed in the form of a cylindrical hole, and a jaw coupling portion711bof the pulley711 may be fitted into the jaw pulley coupling hole701d.

Here, a radius of the jaw pulley coupling hole101dmay be formed to be substantially the same as or relatively greater than a radius of the jaw coupling portion711b. Thus, the jaw coupling portion711bof the pulley711 may be formed to be rotatably coupled to the jaw pulley coupling hole701dof the first jaw701. This will be described in more detail later.

Referring toFIG.56, the second jaw702 disposed to face the first jaw701 may include the shaft pass-through portion702e, the movable coupling hole702c, and the jaw pulley coupling hole702d. The second jaw702 may be formed entirely in an elongated bar shape, the shaft pass-through portion702emay be formed in the distal end, and the jaw pulley coupling hole702dmay be formed in the proximal end.

Referring toFIG.59, the movable coupling hole702cformed in the second jaw702 may be formed to have a predetermined curvature and may be formed in an approximately elliptical shape. A shaft coupling portion721aof a pulley721 may be fitted into the movable coupling hole702c. Here, a short radius of the movable coupling hole702cmay be formed to be substantially the same as or slightly greater than a radius of the shaft coupling portion721a.

Meanwhile, a long radius of the movable coupling hole702cmay be formed to be relatively greater than the radius of the shaft coupling portion721a. Thus, the shaft coupling portion721ais formed to be movable to a certain degree in the movable coupling hole702cin a state in which the shaft coupling portion721aof the pulley721 is fitted into the movable coupling hole702cof the second jaw702. This will be described in more detail later.

Meanwhile, the jaw pulley coupling hole702dis formed in the form of a cylindrical hole, and a jaw coupling portion721bof the pulley721 may be fitted into the jaw pulley coupling hole702d. Here, a radius of the jaw pulley coupling hole702dmay be formed to be substantially the same as or greater than a radius of the jaw coupling portion721b. Thus, the jaw coupling portion721bof the pulley721 may be rotatably coupled to the jaw pulley coupling hole702dof the second jaw702.

Meanwhile, the shaft pass-through portion702emay be formed in the second jaw702 at the distal end side relative to the movable coupling hole702cand the jaw pulley coupling hole702d.

Referring toFIGS.55 and56, the shaft pass-through portion702eformed in the second jaw702 may be formed in a hole shape, and the jaw rotation shaft701eformed in the first jaw701 may be inserted through the shaft pass-through portion702e.

Referring toFIG.57, the pulley711, which is a first jaw pulley, may include the shaft coupling portion711aand the jaw coupling portion711b. The pulley711 is formed entirely in the shape of a rotatable disk and has one surface (lower surface based onFIG.57) on which the shaft coupling portion711aand the jaw coupling portion711bmay be formed to protrude to a certain degree.

As described above, the shaft coupling portion711aof the pulley711 may be fitted into the movable coupling hole701cof the first jaw701, and the jaw coupling portion711bof the pulley711 may be fitted into the jaw pulley coupling hole701dof the first jaw701. The pulley711 may be formed to be rotatable with the rotation shaft741, which is an end tool jaw pulley rotation shaft, as the center of rotation.

Meanwhile, the pulley721, which is a second jaw pulley, may include the shaft coupling portion721aand the jaw coupling portion721b.

The second jaw pulley721 is formed entirely in the form of a rotatable disk and has one surface on which the shaft coupling portion721aand the jaw coupling portion721bmay be formed to protrude to a certain degree. As described above, the shaft coupling portion712aof the pulley712 may be fitted into the movable coupling hole702cof the second jaw702, and the jaw coupling portion712bof the pulley712 may be fitted into the jaw pulley coupling hole702dof the second jaw702. The pulley721 may be formed to be rotatable with the rotation shaft741, which is an end tool jaw pulley rotation shaft, as the center of rotation.

The coupling relationship between the components described above is as follows.

The rotation shaft741, which is an end tool jaw pulley rotation shaft, is sequentially inserted through the shaft coupling portion711aof the pulley711, the movable coupling hole701cof the first jaw701, the movable coupling hole702cof the second jaw702, and the shaft coupling portion721aof the pulley721.

The rotation shaft701e, which is a jaw rotation shaft, is inserted through the shaft pass-through portion702eof the second jaw702.

The shaft coupling portion711aof the pulley711 is fitted into the movable coupling hole701cof the first jaw701, and the jaw coupling portion711bof the pulley711 is fitted into the jaw pulley coupling hole701dof the first jaw701.

At this time, the jaw pulley coupling hole701dof the first jaw701 and the jaw coupling portion711bof the pulley711 are axially coupled to each other so as to be rotatable, and the movable coupling hole701cof the first jaw701 and the shaft coupling portion711aof the pulley711 are movably coupled to each other.

The shaft coupling portion721aof the pulley721 is fitted into the movable coupling hole702cof the second jaw702, and the jaw coupling portion721bof the pulley721 is fitted into the jaw pulley coupling hole702dof the second jaw702.

At this time, the jaw pulley coupling hole702dof the second jaw702 and the jaw coupling portion721bof the pulley721 are axially coupled to each other to be rotatable, and the movable coupling hole702cof the second jaw702 and the shaft coupling portion721aof the pulley721 are movably coupled to each other.

Here, the pulley711 and the pulley721 rotate around the rotation shaft741, which is an end tool jaw pulley rotation shaft. The first jaw701 and the second jaw702 rotate around the rotation shaft701e, which is a jaw rotation shaft. That is, the pulley711 and the first jaw701 have different shafts of rotation. Similarly, the pulley721 and the second jaw702 have different shafts of rotation.

That is, the rotation angle of the first jaw701 is limited to a certain degree by the movable coupling hole701c, but is essentially rotated about the rotation shaft701e, which is a jaw rotation shaft. Similarly, the rotation angle of the second jaw702 is limited to a certain degree by the movable coupling hole702c, but is essentially rotated around the rotation shaft701c, which is a jaw rotation shaft.

Amplification of grip force due to the coupling relationship between the above-described components will be described.

FIG.58 is a plan view illustrating an opening and closing motion of the first jaw of the end tool of the surgical instrument for electrocautery ofFIG.41.FIG.59 is a plan view illustrating an opening and closing motion of the second jaw of the end tool of the surgical instrument for electrocautery ofFIG.41.FIG.60 is a plan view illustrating an opening and closing motion of the first jaw and the second jaw of the end tool of the surgical instrument for electrocautery ofFIG.41.

Referring toFIGS.58 to60, in the electric cauterization surgical instrument10 according to the second embodiment, the coupling structure of the first jaw701 and the second jaw702 forms an X-shaped structure, so that when the first jaw701 and the second jaw702 rotate in a direction of approaching each other (i.e. when the first jaw701 and the second jaw702 are closed), a grip force in a direction of closing the first jaw701 and the second jaw702 further increases. This will be described below in more detail.

As described above, in motions of the first jaw701 and the second jaw702 being opened and closed, there are two shafts that serve as the centers of rotation for the first jaw701 and the second jaw702.

That is, the first jaw701 and the second jaw702 perform an opening and closing motion around two shafts of the rotation shaft741 and the rotation shaft701e. In this case, the centers of rotation of the first jaw701 and the second jaw702 become the rotation shaft701c, and the centers of rotation of rotation of the pulley711 and the pulley721 become the rotation shaft741.

At this time, the rotation shaft741 is a shaft whose position is relatively fixed, and the rotation shaft701eis a shaft whose position is relatively moved linearly. In other words, when the pulley711 and the pulley721 rotate in a state in which the position of the rotation shaft741 is fixed, the first jaw701 and the second jaw702 are opened/closed while the rotation shaft701c, which is a rotation shaft of the first jaw701 and the second jaw702, is moved backward and forward. This will be described below in more detail.

InFIG.58, r1 is a distance from the jaw coupling portion711bof the pulley711 to the shaft coupling portion711a, and a length thereof is constant. Thus, a distance from the rotation shaft741 inserted into the shaft coupling portion711ato the jaw coupling portion711bis also constant as r1.

Meanwhile, r2 ofFIG.58 is a distance from the jaw pulley coupling hole701dof the first jaw701 to the rotation shaft701ethat is a jaw rotation shaft, and a length thereof is constant. Thus, a distance from the jaw coupling portion711bof the pulley711 inserted into the jaw pulley coupling hole701dto the jaw rotation shaft701eis also constant as r2.

Referring toFIG.58, the lengths of r1 and r2 remain constant. Accordingly, when the pulley711 and the pulley721 rotate in the directions of an arrow A1 ofFIG.58 and of an arrow A2 ofFIG.59, respectively, around the rotation shaft741 to perform a closing motion, the first jaw701 and the second jaw702 rotate around the rotation shaft701eas the angle between r1 and r2 changes while the lengths of r1 and r2 remain constant, and at this time, the rotation shaft701eitself is also linearly moved (i.e., is moved forward/backward) by as much as an arrow C1 ofFIG.58 and an arrow C2 ofFIG.59.

That is, assuming that the position of the rotation shaft741, which is an end tool jaw pulley rotation shaft, is fixed, when the first jaw701 and the second jaw702 are closed, a force is applied in a direction in which the rotation shaft701e, which is a jaw rotation shaft, is moved forward (i.e., toward the distal end), and thus the grip force in the direction in which the first jaw701 and the second jaw702 are closed becomes larger.

In other words, since the lengths of r1 and r2 remain constant when the second jaw702 rotates around the jaw rotation shaft701e, when the pulley721 rotates around the rotation shaft741, the angle between r1 and r2 changes while the lengths of r1 and r2 remain constant. That is, the angle between r1 and r2 in a state in which the second jaw702 is open as shown inFIG.59A is relatively greater than the angle between r1 and r2 in a state in which the second jaw702 is closed as shown inFIG.59B.

Thus, when the second jaw702 rotates from the open state to the close state, the angle between r1 and r2 changes, and a force is applied in a direction in which the jaw rotation shaft701epassing through the shaft pass-through portion702eformed in the second jaw702 is moved forward.

In this case, since the rotation shaft741 is a shaft whose position is relatively fixed, the jaw rotation shaft701eis moved forward in the direction of the arrow C1 ofFIG.58 and the direction of an arrow C2 ofFIG.59, and the grip force is further increased in a direction in which the second jaw702 is closed.

In other words, when the pulley711 and the pulley721 rotate around the rotation shaft741, which is a shaft whose relative position is fixed, the angle between r1 and r2 changes while the distance between r1 and r2 remains constant. In addition, when the angle changes as described above, the first jaw701 and the second jaw702 push or pull the rotation shaft701c, and thus the jaw rotation shaft701eis moved forward or backward.

In this case, when the first jaw701 and the second jaw702 rotate in the direction of closing, the grip force is further increased as the rotation shaft701eis moved forward in the directions of the arrow C1 ofFIG.58 and the arrow C2 ofFIG.59.

On the contrary, when the first jaw701 and the second jaw702 rotate in the direction of opening, the rotation shaft701eis moved backward in directions opposite to the arrow C1 ofFIG.58 and the arrow C2 ofFIG.59.

With this configuration, the grip force becomes stronger when the first jaw701 and the second jaw702 are closed, thereby enabling a surgical operator to perform the actuation motion powerfully even with a small force.

That is, as shown inFIG.60, as the first jaw701 and the second jaw702, which have an X-shaped structure, rotate relative to each other around the first rotation shaft741 that is a fixed shaft, the rotation shaft701e, which is a jaw rotation shaft, is moved forward toward the distal end of the end tool700, so that the grip force may be amplified.

FIGS.61 and62 are plan views illustrating an opening and closing motion of the first jaw701 and the second jaw702 in response to an actuation motion of the end tool700 of the surgical instrument for electrocautery ofFIG.41.

Referring toFIGS.61 and62, the first jaw701 and the second jaw702 are connected in an X-shaped structure, and the first jaw701 and the second jaw702 rotate relative to each other as the first jaw pulley711 and the second jaw pulley721 rotate with the fixed rotation shaft741 as the center of rotation, enabling an actuation motion.

In the end tool700 of the electric cauterization surgical instrument10 according to the second embodiment of the present disclosure, as the first jaw701 and the second jaw702 rotate relative to each other, a grip force may be amplified when the jaw rotation shaft701eis moved forward/backward, particularly forward.

Referring toFIG.62, as the pulley711 and the pulley721 rotate in opposite directions with the first rotation shaft741 as the central axis of rotation, the first jaw701 and the second jaw702, which are respectively connected to the pulley711 and the pulley721, rotate in opposite directions and move away from each other, and thus the end tool700 may be in an open state.

Referring toFIGS.61 to65, it may be said that the tissue between the first jaw701 and the second jaw702 is cut as the cutting motion ofFIGS.63 to65 is performed in a state in which the first jaw701 and the second jaw702 are closed as shown inFIG.61.

Here, a first position shown inFIG.63 may be defined as a state in which the blade775 is drawn in toward a proximal end705 of the end tool as much as possible. Alternatively, the first position may also be defined as a state in which the blade775 is located adjacent to the pulley711/pulley712.

Meanwhile, a third position illustrated inFIG.65 may be defined as a state in which the blade775 is withdrawn toward a distal end704 of the end tool700 as much as possible. Alternatively, the third position may also be defined as a state in which the blade775 is spaced away from the pulley711/pulley712 as much as possible.

First, as shown inFIG.62, a tissue to be cut is located between the first jaw701 and the second jaw702 in a state in which the first jaw701 and the second jaw702 are opened, and then an actuation motion is performed to close the first jaw701 and the second jaw702 as shown inFIG.61.

Next, as shown inFIG.63, in a state in which the blade wire307 and the blade775 are located at the first position, currents of different polarities are applied to the first electrode751 and the second electrode752 to cauterize the tissue between the first jaw701 and the second jaw702. At this time, a generator (not shown) configured to supply power to the electrodes may itself perform monitoring of at least some of current, voltage, resistance, impedance, and temperature, and may stop supplying power when the cauterization is completed.

In the state in which the cauterization is completed as described above, when the blade wire307 moves sequentially in the directions of an arrow A1 ofFIG.64 and an arrow A2 ofFIG.65, the blade775 coupled to the blade wire307 moves from the first position at the proximal end705 of the end tool toward the third position at the distal end704 of the end tool, reaching the positions inFIGS.64 and65 in turn.

As such, the blade775 cuts the tissue located between the first jaw701 and the second jaw702 while moving in the X-axis direction.

However, it is to be understood that the linear motion of the blade775 here does not mean a motion in a completely straight line, but rather means a motion of the blade775 to the extent that the blade775 is able to cut the tissue while achieving a linear motion when viewed as a whole, even though the motion is not in a completely straight line, for example, the middle part of the straight line is bent by a certain angle or there is a section having a gentle curvature in a certain section.

Meanwhile, in this state, when the blade wire307 is pulled in the opposite direction, the blade775 coupled to the blade wire307 also returns to the first position.

According to the present disclosure, the multi-joint/multi-degree-of-freedom surgical instrument capable of pitch/yaw/actuation motions may also perform cauterizing and cutting motions.

Referring toFIGS.66 and67, views are illustrated in which a process of performing an opening and closing motion in a state in which the end tool700 of the electric cauterization surgical instrument10 ofFIG.41 is yaw-rotated by +90°.

Referring toFIG.66, the pulley711 and the pulley721 that faces the pulley711 may be rotated around the first rotation shaft741 due to the wires of the power transmission portion300 in the manipulation portion200. InFIG.66, when the pulley711 and the pulley721 rotate in opposite directions, the first jaw701 and the second jaw702 respectively coupled to the pulley711 and the pulley721 may rotate relative to each other in a direction of approaching each other to perform an actuation motion, and as shown inFIG.67, the first jaw701 and the second jaw702 may be in a closed state.

FIGS.66 and67 are views illustrating a process of performing an opening and closing motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.41 is yaw-rotated by −90°.

Referring toFIGS.66 and67, as the pulley711 and the pulley711 are yaw rotatable by −90° with the first rotation shaft741 as the central axis of rotation, and the pulley711 and the pulley711 rotates in different directions, an actuation motion is possible in which the first jaw701 and the second jaw702 respectively connected to the pulley711 and the pulley721 move closer or further away from each other.

Referring toFIGS.66 to69, a blade assembly, specifically, the guide tube770 is connected to the end tool700 at the other end portion, which is opposite one end portion connected to the connection portion400, and may be of constant length.

The guide tube770 may be gently curved with a predetermined radius of curvature when the end tool700, specifically, the first jaw701 and the second jaw702 rotate with the first rotation shaft741 as the central axis of rotation, and may stably provide a movement path for the blade wire307 to be movable between the distal end704 and the proximal end705 of the end tool700.

FIGS.70 and71 are views illustrating a path of the guide tube770 and a movement path of the blade775 during a cutting motion in a state in which the end tool700 of the surgical instrument for electrocautery ofFIG.41 is yaw-rotated by +90°.

Referring toFIGS.70 and71, the end tool700 of the electric cauterization surgical instrument10 according to the second embodiment of the present disclosure is formed such that the jaws701 and702 are able to perform a normal cutting motion even when the jaws are yaw-rotated by +90°.

Specifically, as the blade wire307 emerges from the inside of the guide tube770, and the blade775 connected to the blade wire307 moves in the direction of an arrow A, which is a direction from the proximal end705 toward the distal end704 of the end tool700, a cutting motion may be performed.

FIGS.72 and73 are views illustrating a process of performing an opening and closing motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.41 is pitch-rotated by −90°.FIGS.74 and75 are views illustrating a process of performing an opening and closing motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.41 is pitch-rotated by +90°.FIG.76 is a view illustrating a path of the guide tube in a state in which the end tool of the surgical instrument for electrocautery ofFIG.41 is pitch-rotated by −90°.FIGS.77 and78 are views illustrating a path of the guide tube and a movement path of the blade during a cutting motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.41 is pitch-rotated by −90°.FIG.79 is a perspective view illustrating the surgical instrument for electrocautery ofFIG.41 in a pitch-rotated and yaw-rotated state.FIGS.80 to82 are views illustrating the end tool of the surgical instrument for electrocautery ofFIG.41 performing a cutting motion in a state in which the end tool is pitch-rotated by −90° and simultaneously yaw-rotated by +90°.

FIGS.74 and75 are views illustrating a process of performing an opening and closing motion in a state in which the end tool700 of the surgical instrument for electrocautery ofFIG.41 is pitch-rotated by +90°.FIG.76 is a view illustrating a path of the guide tube770 in a state in which the end tool700 of the surgical instrument for electrocautery ofFIG.41 is pitch-rotated by −90°.FIGS.77 and78 are views illustrating a path of the guide tube and a movement path of the blade during a cutting motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.41 is pitch-rotated by −90°.

Referring toFIGS.72 to78, the end tool700 of the electric cauterization surgical instrument10 according to the second embodiment of the present disclosure is formed such that the jaws701 and702 are able to perform a cutting motion normally even when the jaws are pitch-rotated by −90° and +90°.

Meanwhile,FIG.79 is a view illustrating a state in which the jaws are pitch-rotated by −90° and simultaneously yaw-rotated by +90°, andFIGS.80 to82 are views illustrating a state in which the end tool of the surgical instrument for electrocautery ofFIG.41 performs a cutting motion in a state in which the end tool is pitch-rotated by −90° and simultaneously yaw-rotated by +90°.

Referring toFIGS.79 to82, the end tool700 of the electric cauterization surgical instrument10 according to the second embodiment of the present disclosure is formed such that the jaws701 and702 are able to perform a cutting motion normally even when the jaws are pitch-rotated by −90° and simultaneously yaw-rotated by +90°.

Modified Example of Second Embodiment-Disposing Auxiliary Pulley on End Tool Hub

Hereinafter, an end tool700 of a surgical instrument according to a modified example of the second embodiment of the present disclosure will be described. Here, the end tool700 of the surgical instrument according to the modified example of the second embodiment of the present disclosure is different from the end tool of the surgical instrument according to the second embodiment of the present disclosure described above in that the configuration of an end tool hub760′ and the configuration of auxiliary pulleys712 and722 are different. The configuration changed from the second embodiment as described above will be described in detail later.

FIGS.83 to85 are views illustrating the end tool of the surgical instrument for electrocautery according to the modified example of the second embodiment of the present disclosure.

Referring toFIGS.83 to85, the end tool700 of the modified example of the second embodiment of the present disclosure includes a pair of jaws for performing a grip motion, specifically a first jaw701 and a second jaw702, and here, each of the first jaw701 and the second jaw702 or a component encompassing the first jaw701 and the second jaw702 may be referred to as a jaw703.

The end tool700 according to the modified example of the second embodiment may include a pulley711, the pulley712, a pulley713, a pulley714, a pulley715, and a pulley716 that are associated with a rotational motion of the first jaw701. In addition, the end tool700 may include a pulley721, the pulley722, a pulley723, a pulley724, a pulley725, and a pulley726 that are associated with a rotational motion of the second jaw702.

Here, the pulleys facing each other are illustrated in the drawings as being formed parallel to each other, but the concept of the present disclosure is not limited thereto, and each of the pulleys may be variously formed with a position and a size suitable for the configuration of the end tool.

The end tool700 according to the modified example of the second embodiment of the present disclosure may further include the pulley712 and the pulley722 as compared to the end tool700 according to the second embodiment of the present disclosure illustrated with reference toFIG.43.

Referring toFIGS.84 and85, the pulley712 functions as an end tool first jaw auxiliary pulley, and the pulley722 functions as an end tool second jaw auxiliary pulley, and these two components may collectively be referred to as end tool jaw auxiliary pulleys or simply auxiliary pulleys.

In detail, the pulley712 and the pulley722, which are end tool jaw auxiliary pulleys, may be additionally provided on one side of the pulley711 and one side of the pulley721, respectively. In other words, the pulley712, which is an auxiliary pulley, may be disposed between the pulley711 and the pulley713/pulley714. In addition, the pulley722, which is an auxiliary pulley, may be disposed between the pulley721 and the pulley723/pulley724.

The pulley712 and the pulley722 may be formed to be rotatable independently of each other around a second rotation shaft742.

The pulley712 and the pulley722 may serve to increase rotation angles of the first jaw701 and the second jaw702, respectively, by coming into contact with a wire305, which is a first jaw wire, and a wire302, which is a second jaw wire, and changing the arrangement paths of the wire305 and the wire302 to a certain degree.

That is, when the auxiliary pulleys are not disposed, each of the first jaw701 and the second jaw702 may rotate only up to a right angle, but in the modified example of the second embodiment, by additionally providing the pulley712 and the pulley722, which are auxiliary pulleys, the effect of increasing the maximum rotation angle by a certain angle can be achieved.

This enables a motion in which two jaws of the end tool700 have to be spread apart for an actuation motion in a state in which the two jaws are yaw-rotated together by 90° in the clockwise or counterclockwise direction.

In other words, a feature of increasing the range of yaw rotation in which an actuation motion is possible may be obtained through the pulley712 and the pulley722. This will be described below in more detail.

When the auxiliary pulleys are not disposed, since the first jaw wire305 is fixedly coupled to the end tool first jaw pulley711, and the second jaw wire302 is fixedly coupled to the end tool second jaw pulley721, each of the end tool first jaw pulley711 and the end tool second jaw pulley721 may rotate up to 90°.

In this case, when the actuation motion is performed in a state in which the first jaw701 and the second jaw702 are located at a 90° line, the first jaw701 may be spread, but the second jaw702 may not be rotated beyond 90°. Accordingly, when the first jaw701 and the second jaw702 perform a yaw motion over a certain angle, there was a problem that an actuation motion is not smoothly performed.

In order to address such a problem, in the electric cauterization surgical instrument10 of the present disclosure, the pulley712 and the pulley722, which are auxiliary pulleys, are additionally disposed at one side of the pulley711 and one side of the pulley721, respectively. As described above, as the arrangement paths of the wire305, which is a first jaw wire, and the wire302, which is a second jaw wire, are changed to a certain degree by disposing the pulley712 and the pulley722, a tangential direction of the wires305 and302 is changed, and accordingly, a fastening member324 for coupling the wire302 and the pulley721 is additionally rotatable by a certain angle.

That is, a fastening member326, which is a coupling portion of the wire302 and the pulley721, is rotatable until being located on a common internal tangent of the pulley721 and the pulley722. Similarly, a fastening member323, which is a coupling portion of the wire305 and the pulley711, is rotatable until being located on a common internal tangent of the pulley711 and the pulley712, so that the range of rotation may be increased.

In other words, due to the pulley712 that is an auxiliary pulley, a wire301 and a wire305, which are two strands of the first jaw wire wound around the pulley712, are disposed at one side with respect to a plane perpendicular to the Y-axis and passing through the X-axis. Simultaneously, due to the pulley722, the wires302 and306, which are two strands of the second jaw wire wound around the pulley721, are disposed at the other side with respect to the plane perpendicular to the Y-axis and passing through the X-axis.

In other words, the pulley713 and the pulley714 are disposed at one side with respect to the plane perpendicular to the Y-axis and passing through the X-axis, and the pulley723 and the pulley724 are disposed at the other side with respect to the plane perpendicular to the Y-axis and passing through the X-axis.

In other words, the wire305 is located on the internal tangent of the pulley711 and the pulley712, and the rotation angle of the pulley711 is increased due to the pulley712. In addition, the wire302 is located on the internal tangent of the pulley721 and the pulley722, and the rotation angle of the pulley721 is increased due to the pulley722.

According to the present disclosure, the rotation radii of the first jaw701 and the second jaw702 increase, so that an effect of increasing a yaw motion range in which a normal opening/closing actuation motion can be performed may be obtained.

Referring toFIG.38, a first rotation shaft741 and a second rotation shaft742 may be inserted through the end tool hub760′ according to the modified example of the second embodiment of the present disclosure. Instead of respectively forming the first wire guide portion and the second wire guide portion on the surfaces of a first jaw pulley coupling portion762aand a second jaw pulley coupling portion762bfacing each other as in the end tool hub760 according to the second embodiment of the present disclosure, the pulley712 and the pulley722, which are configured as separate components from the end tool hub760′ and are able to be axially coupled to the second rotation shaft742 that is inserted through the end tool hub760′, are additionally provided and allowed to function as auxiliary pulleys.

The second rotation shaft742 inserted through the end tool hub760′ may include two shafts including a first sub-shaft and a second sub-shaft that face each other and are disposed to be spaced apart from each other by a certain distance. The second rotation shaft742 is divided into two parts and spaced apart from each other by a certain distance, and thus a guide tube770 may pass through the end tool hub760′ and a pitch hub750 through between the two parts.

Referring toFIG.83, the first rotation shaft741, the second rotation shaft742, a third rotation shaft743, and a fourth rotation shaft744 may be arranged sequentially from a distal end704 toward a proximal end705 of the end tool700. Accordingly, starting from the distal end704, the first rotation shaft741 may be referred to as a first pin, the second rotation shaft742 may be referred to as a second pin, the third rotation shaft743 may be referred to as a third pin, and the fourth rotation shaft744 may be referred to as a fourth pin.

As compared to the second embodiment, the end tool700 of the modified example of the second embodiment of the present disclosure has the same configuration as the end tool700 according to the second embodiment, except that the pulley721 and the pulley722, which are axially coupled to the end tool hub760′ by the second rotation shaft742, are provided as separate components instead of being integrally formed with a body portion761 in the end tool hub760′ and function as auxiliary pulleys, and thus a detailed description thereof will be omitted in the overlapping range.

Third Embodiment of Surgical Instrument for Electrocautery

FIG.86 is a perspective view illustrating a surgical instrument for electrocautery according to a third embodiment of the present disclosure.FIGS.87 to92 are plan views illustrating an end tool of the surgical instrument for electrocautery ofFIG.86.

Referring toFIG.86, an electric cauterization surgical instrument10 according to the third embodiment of the present disclosure includes an end tool800, a manipulation portion200, a power transmission portion300, and a connection portion400.

As compared to the electric cauterization surgical instrument10 according to the second embodiment, the electric cauterization surgical instrument10 according to the third embodiment of the present disclosure is different from in a configuration of the end tool800, specifically, a yaw hub880, an actuation link892, and the like, which will be described in detail below.

Referring toFIGS.86 and87, the end tool800 according to the third embodiment of the present disclosure is formed at the other end of the connection portion400, and performs necessary motions for surgery by being inserted into a surgical site. In an example of the end tool800, as illustrated inFIG.86, a pair of jaws803 for performing a grip motion may be used.

However, the concept of the present disclosure is not limited thereto, and various devices for performing surgery may be used as the end tool800. For example, a configuration of a cantilever cautery may also be used as the end tool800.

The end tool800 is connected to the manipulation portion200 by the power transmission portion300, and receives a driving force of the manipulation portion200 through the power transmission portion300 to perform a motion necessary for surgery, such as gripping, cutting, suturing, or the like.

Here, the end tool800 of the electric cauterization surgical instrument10 according to the third embodiment of the present disclosure is formed to be rotatable in at least one direction, and for example, the end tool800 may be formed to perform a pitch motion around a Y-axis ofFIG.86 and simultaneously perform a yaw motion and an actuation motion around a Z-axis ofFIG.86.

End Tool According to Third Embodiment

Hereinafter, the end tool800 of the electric cauterization surgical instrument10 ofFIG.86 will be described in more detail.

FIG.86 is a perspective view illustrating the surgical instrument for electrocautery according to the third embodiment of the present disclosure.FIGS.87 to92 are views illustrating the end tool of the surgical instrument for electrocautery ofFIG.86.

Here,FIG.87 illustrates a state in which an end tool hub860 and a pitch hub850 are coupled, andFIG.88 illustrates a state in which the end tool hub860, the yaw hub880, and the pitch hub850 are removed.FIG.89 illustrates a state in which the yaw hub880 and the end tool hub860 are connected to the end tool, andFIG.90 illustrates a state in which a first jaw801 and a second jaw802 are removed. Meanwhile,FIG.91 is a view mainly illustrating wires, andFIG.92 is a view mainly illustrating pulleys.

Referring toFIGS.87,88,91, and92, the end tool800 according to the third embodiment of the present disclosure may include a pair of jaws for performing a grip motion, that is, the first jaw801 and the second jaw802. Here, each of the first jaw801 and the second jaw802, or a component encompassing the first jaw801 and the second jaw802 may be referred to as the jaw803.

In addition, the end tool800 may include a pulley891, a pulley813, a pulley814, a pulley815, and a pulley816, which are associated with a rotational motion of the first jaw801. In addition, the end tool800 may include a pulley881, a pulley823, a pulley824, a pulley825, and a pulley826, which are associated with a rotational motion of the second jaw802.

Here, the pulleys facing each other are illustrated in the drawings as being formed parallel to each other, but the concept of the present disclosure is not limited thereto, and each of the pulleys may be variously formed with a position and a size suitable for the configuration of the end tool.

Referring toFIG.87, the end tool800 of the third embodiment of the present disclosure may include the end tool hub860, the pitch hub850, and the yaw hub880.

A first rotation shaft841, which will be described later, may be inserted through the end tool hub860, and the end tool hub860 may internally accommodate at least some of the pulley891 and the pulley881, which are axially coupled to the first rotation shaft841.

The end tool hub860 according to the third embodiment of the present disclosure is the same as the end tool hubs660 and760 according to the first and third embodiments, and thus a detailed description thereof will be omitted in the overlapping range.

Referring toFIG.87, the pitch hub850 may have a third rotation shaft843 and a fourth rotation shaft844, which will be described later, inserted therethrough, and may be axially coupled to a first pitch pulley portion863aand a second pitch pulley portion863bof the end tool hub860 by the third rotation shaft843. Accordingly, the end tool hub860 may be formed to be rotatable around the third rotation shaft843 with respect to the pitch hub850.

In addition, the pitch hub850 may internally accommodate at least some of the pulley813, the pulley814, the pulley823, and the pulley824 that are axially coupled to the third rotation shaft843. In addition, the pitch hub850 may internally accommodate at least some of the pulley815, the pulley816, the pulley825, and the pulley826 that are axially coupled to the fourth rotation shaft844.

One end portion of the pitch hub850 is connected to the end tool hub860, and the other end portion of the pitch hub850 is connected to the connection portion400.

Referring toFIG.87, the first rotation shaft841 may function as an end tool jaw pulley rotation shaft, the third rotation shaft843 may function as an end tool pitch rotation shaft, and the fourth rotation shaft844 may function as an end tool pitch auxiliary rotation shaft of the end tool100.

Here, each of the rotation shafts may be divided into two parts, and the respective divided rotation shafts may be spaced apart from each other. Each of the rotation shafts is formed by being divided into two parts as described above to allow a guide tube870 to pass through the end tool hub860 and the pitch hub850.

That is, the guide tube870 may pass between a first sub-shaft and a second sub-shaft of each of the rotation shafts. This will be described in more detail later. Here, the first sub-shaft and the second sub-shaft may be disposed on the same axis or may be disposed to be offset to a certain degree.

Meanwhile, it is illustrated in the drawings that each of the rotation shafts is formed by being divided into two parts, but the concept of the present disclosure is not limited thereto. That is, each of the rotation shafts is formed to be curved in the middle such that an escape path for the guide tube870 is formed.

Referring toFIGS.87 and88, an actuation rotation shaft845 may be further provided in the end tool800 according to the third embodiment of the present disclosure. In detail, the actuation rotation shaft845 may be provided in a coupling portion of the first jaw801 and the second jaw802, and the second jaw802 rotates around the actuation rotation shaft845 while the first jaw801 is fixed, thereby performing an actuation motion. Here, the actuation rotation shaft845 may be disposed closer to a distal end804 than the first rotation shaft841 is.

Here, in the end tool800 of the third embodiment of the present disclosure, the first rotation shaft841, which is a yaw rotation shaft, and the actuation rotation shaft845 are provided separately rather than as the same shaft.

That is, by forming the first rotation shaft841, which is a rotation shaft of the pulley881/pulley891 that are jaw pulleys and a rotation shaft of a yaw motion, and the actuation rotation shaft845, which is a rotation shaft of the second jaw802 with respect to the first jaw801 and a rotation shaft of an actuation motion, to be spaced apart from each other by a certain distance, a space in which the guide tube870 and the blade wire307 accommodated therein can be gently bent may be secured. This actuation rotation shaft845 will be described in more detail later.

The pulley891 functions as an end tool first jaw pulley, and the pulley881 functions as an end tool second jaw pulley. The pulley891 may also be referred to as a first jaw pulley, and the pulley881 may also be referred to as a second jaw pulley, and these two components may collectively be referred to as end tool jaw pulleys or simply jaw pulleys.

The pulley891 and the pulley881, which are end tool jaw pulleys, are formed to face each other, and are formed to be rotatable independently of each other around the first rotation shaft841 which is an end tool jaw pulley rotation shaft.

In this case, the pulley891 and the pulley881 are formed to be spaced apart from each other by a certain distance, and a blade assembly may be accommodated therebetween.

In other words, the blade assembly including the guide tube870 may be disposed between the pulley891 and the pulley881.

Meanwhile, the end tool800 of the third embodiment of the present disclosure may further include components such as a first electrode851, a second electrode852, the guide tube870, and a blade875 in order to perform a cauterizing motion and a cutting motion.

Here, components related to the driving of the blade, such as the guide tube870 and the blade875, may be collectively referred to as a blade assembly. In one modified example of the present disclosure, by disposing the blade assembly including the blade875 between the pulley891, which is a first jaw pulley, and the pulley881, which a second jaw pulley, the end tool800 is able to perform the cutting motion using the blade in addition to the pitch and yaw motions. Components for performing a cauterizing motion and a cutting motion in the present embodiment are substantially the same as those described in the first and second embodiments, and thus a detailed description thereof will be omitted herein.

The electric cauterization surgical instrument10 according to the third embodiment of the present disclosure may include a wire301, a wire302, the wire303, the wire304, a wire305, a wire306, and a blade wire307, as in the first embodiment of the present disclosure.

(Jaw-Link-Pulley Connection Structure)

Hereinafter, a jaw-link-pulley connection structure in the end tool800 according to the third embodiment of the present disclosure will be described in more detail.

Referring toFIGS.87 to101, the end tool800 of the third embodiment of the present disclosure includes the first jaw801, the second jaw802, the yaw hub880, an actuation link592, the first jaw pulley891, and the second jaw pulley881. Hereinafter, the pulley891 is referred to as the first jaw pulley891, and the pulley881 is referred to as the second jaw pulley881.

Referring toFIGS.97 to100, the first jaw pulley891 may be formed as a kind of multi-layered pulley. In other words, the first jaw pulley891 may be formed in a form in which two pulleys are combined, and two grooves may be formed on an outer circumferential surface of the first jaw pulley891.

In detail, a first coupling portion891amay be formed on one surface of the first jaw pulley891, and a second coupling portion891bmay be formed in the shape of a groove on the other surface opposite to the one surface on which the first coupling portion891ais formed.

Here, the positions of the first coupling portion891aand the second coupling portion891bare positions allowing the wire301 and the wire305 to overlap each other. In other words, the first coupling portion891aand the second coupling portion891bmay be formed so that at least some of the wire302 and the wire306 wound around the first jaw pulley891 overlap each other.

In other words, the first coupling portion891aand the second coupling portion891bare asymmetrically disposed when viewed on an XY plane, so that the first coupling portion891aand the second coupling portion891bare disposed to be biased in any one region of the second jaw pulley891.

In other words, the first coupling portion891amay be formed at a position at which the wire301 may be wound around the outer circumferential surface of the first jaw pulley891 such that the central angle is an angle between 90° and 360°. Similarly, the second coupling portion891bmay be formed at a position at which the wire305 may be wound around the outer circumferential surface of the second jaw pulley891 such that the central angle is an angle between 90° and 360°.

In addition, one end portion of the wire301 is coupled to a fastening member334a, which may be coupled to the first coupling portion891aof the first jaw pulley891. One end portion of the wire305 is coupled to a fastening member334b, which may be coupled to the second coupling portion891bof the first jaw pulley891.

When the wire301 is referred to as a first jaw wire R and the wire305 is referred to as a first jaw wire L, the first coupling portion891ato which the first jaw wire R(301) is coupled is formed on a side opposite to one side to which the first jaw wire R(301) is input, so that a rotation angle of the first jaw pulley891 is increased by increasing the length of the first jaw wire R(305) wound around the first jaw pulley891.

Also, the second coupling portion891bto which the first jaw wire L(302) is coupled is formed on one side opposite to the other side to which the first jaw wire L(302) is input, so that the rotation angle of the first jaw pulley891 may be increased by increasing the length of the first jaw wire L(302) wound around the first jaw pulley891.

A rotation radius of the second jaw pulley891 may be increased due to the first coupling portion891aand the second coupling portion891b. In addition, by increasing the length of the wire301/wire305 wound around the first jaw pulley891 as described above, a long stroke of the actuation link892 may be secured. This will be described in more detail later. Referring toFIG.90, the yaw hub880 is located between the first and second jaws801 and802 and the first and second jaw pulleys891 and881, and may include a yaw hub body882.

The first jaw pulley891 may be formed at one end portion of the yaw hub880. A guide slit883 may be formed on the other end portion of the yaw hub880 in a longitudinal direction. A guide pin893 formed to protrude from the actuation link892 to be described later may be fitted into the guide slit883.

Referring toFIGS.90 and93, a through hole through which the actuation rotation shaft845 is inserted may be formed in the yaw hub880 at one side of the guide slit883. Referring toFIG.93, the second jaw pulley881 is integrally formed on one side of the yaw hub880, but the present disclosure is not limited thereto, and various modifications are possible.

Although not shown in the drawings, it is also possible that the second jaw pulley881 and the yaw hub880 are each formed as a separate member, and the second jaw pulley881 may be fixedly coupled to the yaw hub880, specifically, the yaw hub body882.

In addition, two divided first rotation shafts841 may be inserted through the first jaw pulley891 and the second jaw pulley881, respectively.

Since the second jaw pulley881 is integrally formed with or fixedly coupled to the yaw hub880 as described above, the yaw hub880 does not rotate with respect to the second jaw pulley881, and when the second jaw pulley881 rotates around the first rotation shaft841, the yaw hub580 may also rotate around the first rotation shaft841 together with the second jaw pulley881.

Referring toFIGS.90 and91, the actuation rotation shaft845 may be disposed on the yaw hub880. The actuation rotation shaft845 may be divided into two parts, which may be disposed to be spaced apart from each other by a certain distance, and the guide tube870, the blade wire307 accommodated in the guide tube870, and the blade875 may pass through a space formed between the two divided actuation rotation shafts845.

Referring toFIG.90, the yaw hub880, specifically, a guide slit883 formed in the yaw hub body882 may be formed to extend in a longitudinal direction between the actuation rotation shaft845 and the yaw rotation shaft841.

Referring toFIG.90, the guide slit883 may be formed to have the same width in the longitudinal direction, and the guide pin893 formed to protrude from the actuation link892 is movable, specifically, linearly movable in the guide slit883.

Referring toFIG.93, on the other side of the yaw hub880 opposite to one side thereof on which the second jaw pulley881 is formed, an actuation pulley coupling portion885 may be formed to protrude so as to be coupled to the first jaw pulley891.

The actuation pulley coupling portion885 may share a central axis with the yaw rotation shaft841. However, the present disclosure is not limited thereto, and various modifications are possible, including spacing apart and placing the actuation pulley coupling portion885 and the yaw hub880 side by side.

Referring toFIG.101, the actuation link892 may be formed to extend in a longitudinal direction. The actuation link892 may include a link body892aand a bending portion892b. The link body892ais a portion formed to extend in the longitudinal direction, and the bending portion892bmay be connected to the link body892awith at least one bend.

Accordingly, one side of the actuation link892 in which the bending portion892bis located may be formed in a “U”-shape.

Referring toFIG.101, a pin coupling hole (no reference number is assigned) may be formed in one surface of the bending portion892bthat is disposed in parallel with the link body892ato be spaced apart therefrom by a certain distance.

A pin coupling hole may also be formed in one surface of the link body892afacing the bending portion892bto correspond to the pin coupling hole of the bending portion892b. The guide pin893 may be coupled to the pin coupling hole. A plurality of guide pins893 may be provided, and may be coupled to the pin coupling holes formed in the respective facing surfaces of the bending portion892band the link body892a.

The plurality of guide pins893 may be disposed to be spaced apart from each other by a certain distance, and one side region of the U-shaped actuation link892 formed with the bending portion892band the link body892amay provide a movement path so that the guide tube870 can pass therethrough. Due to the ‘U’ shaped region formed by the bending portion892band the link body892a, the movement path of the guide tube870 moving inside the yaw hub880 and the end tool hub860 is not disturbed when the actuation link892 linearly moves.

Referring toFIG.101, a link through-hole892cmay be formed on the other side of the link body892aopposite to one side to which the bending portion892bis connected. A protrusion891cformed on the first jaw pulley891 may be axially coupled to and fitted into the link through-hole892c.

Accordingly, when the first jaw pulley891 rotates, the actuation link892 moves while rotating around the protrusion891c.

The guide pin893 provided in the actuation link892 is fitted into the guide slit883 formed in the yaw hub880 and is movable along the shape of the guide slit883.

The guide pin893 passing through the guide slit883 may be fitted into each of slots801aand802arespectively formed in the first jaw801 and the second jaw802. The first jaw801 and the second jaw802 have an X-shaped structure, and the guide pin893 may be fitted into the slot801aformed in the first jaw801 and the slot801bformed in the second jaw802 at the same time.

The first jaw801 and the second jaw802 may perform an actuation motion while moving away from or close to each other with the actuation rotation shaft845 as the center of rotation.

Referring toFIGS.102 to104, when the first jaw pulley891 rotates in an A1 direction, the actuation link892 axially coupled to the protrusion891cformed in the first jaw pulley891 is moved in a B1 direction. Specifically, the guide pin893 provided in the actuation link892 is moved linearly along the guide slit883 formed in the yaw hub880, and the guide pin893 is fitted into the slots801aand802arespectively formed in the first jaw801 and the second jaw802, so that the guide pin893 pushes the first jaw801 and the second jaw802. Thus, as the actuation link892 is moved, the first jaw801 and the second jaw802 may perform an actuation motion while rotating around the actuation rotation shaft845 as the center of rotation.

Referring toFIG.103, as the actuation link892 is moved toward the distal end, the first jaw801 and the second jaw802 may perform an actuation motion in C1 directions around the actuation rotation shaft845 along the C1 directions.

Referring toFIG.104, when the guide pin893 is moved as much as possible toward the distal end in the slots801aand802arespectively formed in the first jaw801 and the second jaw802, the first jaw801 and the second jaw802 may be further spread apart in C2 directions.

In addition, the first jaw pulley891 is formed in a multi-layered structure, and the first jaw wires301 and305 are wound so that the first jaw wires301 and305 overlap in different layers, and as a result, the length of the winding on the first jaw pulley891 can be increased, and the rotation angle of the first jaw pulley891 can be increased.

FIGS.105 to108 are perspective views illustrating an actuation motion of the end tool of the surgical instrument for electrocautery ofFIG.86. The guide pin893 provided in the actuation link892 is movable along the slots801aand802arespectively formed in the first jaw801 and the second jaw802, and accordingly, the first jaw801 and the second jaw802 may perform an actuation motion with the actuation rotation shaft845 as the central axis of rotation.

FIGS.109 to111 are partial cross-sectional views illustrating an operation of the blade of the end tool of the surgical instrument for electrocautery ofFIG.86. The operation of the blade875 is the same as those of the first and second embodiments, and thus a detailed description thereof will be omitted in the overlapping range.

FIGS.112 and113 are bottom views illustrating a process of performing an opening and closing motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.86 is yaw-rotated by +90°.

The guide slit883 formed in the yaw hub880 may be formed in a straight line direction, and the actuation rotation shaft845 may be disposed along a longitudinal central axis of the guide slit883.

The slots801aand802arespectively formed in the first jaw801 and the second jaw802 may be formed to be inclined at a certain angle with the longitudinal central axis of the guide slit883 formed in the yaw hub880.

This causes the first jaw801 and second jaw803 to spread apart from each other as shown inFIG.113 when the actuation link892, specifically the guide pin893 that is moved by receiving power from the first jaw pulley891, is moved forward toward the actuation rotation shaft845 while the actuation rotation shaft845 remains fixed.

Referring toFIGS.114 and115, the first jaw pulley891 rotates in a state in which the end tool of the surgical instrument for electrocautery ofFIG.86 is yaw-rotated by +90°, and the guide pin893 provided in the actuation link892 connected to the first jaw pulley891 is moved through the guide slit883 formed in the yaw hub880 and the slots801aand802arespectively formed in the first jaw801 and the second jaw802, so that an actuation motion can be performed even in a yaw rotated state.

Referring toFIGS.116 to125, there is room for problems when the guide tube870 is in contact with the actuation link892 while the end tool800 is yaw-rotated, but the actuation link892 of the present disclosure includes the link body892aand the bending portion892bconnected thereto, which form a “U” shape, to prevent the contact with the guide tube870, allowing the blade wire307 and the guide tube870 to move stably with respect to yaw, pitch, and actuation motions of the end tool800.

Referring toFIGS.126 to136, the end tool800 of the electric cauterization surgical instrument10 according to the third embodiment of the present disclosure is formed such that the jaws801 and802 are able to perform a cutting motion normally even when the jaws arc pitch-rotated and simultaneously yaw-rotated.

Here, in the end tool800 of the third embodiment of the present disclosure, a pin/slot-type structure is employed to secure a grip force in the actuation motion.

In detail, in the pin/slot-type structure, the actuation link892 must move a longer distance to rotate the first jaw801 by the same amount (that is, the actuation link892 needs to have a long stroke). In addition, in order for the actuation link590 to move a longer distance, the first jaw pulley891 should rotate further. In other words, when the first jaw pulley891 rotates further to rotate the first jaw801 by the same amount, a greater force may be applied to the first jaw801 by as much as the first jaw pulley891 rotates further, so that a grip force in the actuation motion may be amplified.

In addition, in order to rotate the first jaw pulley891 further as described above, the first jaw pulley891 is formed in a multi-layered structure as described above to make the lengths of the wires301 and305 wound around the first jaw pulley891 to be longer, thereby securing a long stroke of the actuation link892.

Modified Example of Third Embodiment-Disposing Auxiliary Pulley on End Tool Hub

Hereinafter, an end tool800 of a surgical instrument according to a modified example of the third embodiment of the present disclosure will be described. Here, the end tool300 of the surgical instrument according to the modified example of the third embodiment of the present disclosure is different from the end tool of the surgical instrument according to the third embodiment of the present disclosure described above in that the configuration of an end tool hub860′ and the configuration of auxiliary pulleys812 and822 are different. The configuration changed from the third embodiment as described above will be described in detail later.

FIGS.137 to139 are views illustrating the end tool of the surgical instrument for electrocautery according to the modified example of the third embodiment of the present disclosure.

Referring toFIGS.137 and138, the end tool800 of the modified example of the third embodiment of the present disclosure includes a pair of jaws for performing a grip motion, specifically a first jaw801 and a second jaw802, and here, each of the first jaw801 and the second jaw802 or a component encompassing the first jaw801 and the second jaw802 may be referred to as a jaw803.

The end tool800 according to the modified example of the third embodiment may include a pulley811, the pulley812, a pulley813, a pulley814, a pulley815, and a pulley816 that are associated with a rotational motion of the first jaw801. In addition, the end tool800 may include a pulley821, the pulley822, a pulley823, a pulley824, a pulley825, and a pulley826 that are associated with a rotational motion of the second jaw802.

Here, the pulleys facing each other are illustrated in the drawings as being formed parallel to each other, but the concept of the present disclosure is not limited thereto, and each of the pulleys may be variously formed with a position and a size suitable for the configuration of the end tool.

The end tool800 according to the modified example of the third embodiment of the present disclosure may further include the pulley812 and the pulley822 as compared to the end tool800 according to the third embodiment of the present disclosure illustrated with reference toFIG.86.

Referring toFIGS.137 to139, the pulley812 functions as an end tool first jaw auxiliary pulley, and the pulley822 functions as an end tool second jaw auxiliary pulley, and these two components may collectively be referred to as end tool jaw auxiliary pulleys or simply auxiliary pulleys.

In detail, the pulley812 and the pulley822, which are end tool jaw auxiliary pulleys, may be additionally provided on one side of the pulley811 and one side of the pulley821, respectively. In other words, the pulley812, which is an auxiliary pulley, may be disposed between the pulley811 and the pulley813/pulley814. In addition, the pulley822, which is an auxiliary pulley, may be disposed between the pulley821 and the pulley823/pulley824.

The pulley812 and the pulley822 may be formed to be rotatable independently of each other around a second rotation shaft842.

The pulley812 and the pulley822 may serve to increase rotation angles of the first jaw801 and the second jaw802, respectively, by coming into contact with a wire305, which is a first jaw wire, and a wire302, which is a second jaw wire, and changing the arrangement paths of the wire305 and the wire302 to a certain degree.

That is, when the auxiliary pulleys are not disposed, each of the first jaw801 and the second jaw802 may rotate only up to a right angle, but in the modified example of the third embodiment, by additionally providing the pulley812 and the pulley822, which are auxiliary pulleys, the effect of increasing the maximum rotation angle by a certain angle can be achieved.

This enables a motion in which two jaws of the end tool800 have to be spread apart for an actuation motion in a state in which the two jaws are yaw-rotated together by 90° in the clockwise or counterclockwise direction.

In other words, a feature of increasing the range of yaw rotation in which an actuation motion is possible may be obtained through the pulley812 and the pulley822. This will be described below in more detail.

When the auxiliary pulleys are not disposed, since the first jaw wire305 is fixedly coupled to the end tool first jaw pulley811, and the second jaw wire302 is fixedly coupled to the end tool second jaw pulley821, each of the end tool first jaw pulley811 and the end tool second jaw pulley821 may rotate up to 90°.

In this case, when the actuation motion is performed in a state in which the first jaw801 and the second jaw802 are located at a 90° line, the first jaw801 may be spread, but the second jaw802 may not be rotated beyond 90°. Accordingly, when the first jaw801 and the second jaw802 perform a yaw motion over a certain angle, there was a problem that an actuation motion is not smoothly performed.

In order to address such a problem, in the electric cauterization surgical instrument10 of the present disclosure, the pulley812 and the pulley822, which are auxiliary pulleys, are additionally disposed at one side of the pulley811 and one side of the pulley821, respectively. As described above, as the arrangement paths of the wire305, which is a first jaw wire, and the wire302, which is a second jaw wire, are changed to a certain degree by disposing the pulley812 and the pulley822, a tangential direction of the wires305 and302 is changed, and accordingly, a fastening member324 for coupling the wire302 and the pulley821 is additionally rotatable by a certain angle.

That is, a fastening member326, which is a coupling portion of the wire302 and the pulley821, is rotatable until being located on a common internal tangent of the pulley821 and the pulley822. Similarly, a fastening member323, which is a coupling portion of the wire305 and the pulley811, is rotatable until being located on a common internal tangent of the pulley811 and the pulley812, so that the range of rotation may be increased.

In other words, due to the pulley812 that is an auxiliary pulley, the wires301 and305, which are two strands of the first jaw wire wound around the pulley812, are disposed at one side with respect to a plane perpendicular to the Y-axis and passing through the X-axis. Simultaneously, due to the pulley822, the wires302 and306, which are two strands of the second jaw wire wound around the pulley821, are disposed at the other side with respect to the plane perpendicular to the Y-axis and passing through the X-axis.

In other words, the pulley813 and the pulley814 are disposed at one side with respect to the plane perpendicular to the Y-axis and passing through the X-axis, and the pulley823 and the pulley824 are disposed at the other side with respect to the plane perpendicular to the Y-axis and passing through the X-axis.

In other words, the wire305 is located on the internal tangent of the pulley811 and the pulley812, and the rotation angle of the pulley811 is increased due to the pulley812. In addition, the wire302 is located on the internal tangent of the pulley821 and the pulley822, and the rotation angle of the pulley821 is increased due to the pulley822.

According to the present disclosure, the rotation radii of the first jaw801 and the second jaw802 increase, so that an effect of increasing a yaw motion range in which a normal opening/closing actuation motion can be performed may be obtained.

As compared to the third embodiment, the end tool800 of the modified example of the third embodiment of the present disclosure has the same configuration as the end tool800 according to the third embodiment, except that the pulley821 and the pulley822, which are axially coupled to the end tool hub860′ by the second rotation shaft842, are provided as separate components instead of being integrally formed with a body portion861 in the end tool hub860′ and function as auxiliary pulleys, and thus a detailed description thereof will be omitted in the overlapping range

Fourth Embodiment of Surgical Instrument for Electrocautery

FIG.140 is a perspective view illustrating a surgical instrument for electrocautery according to a fourth embodiment of the present disclosure.FIGS.141 to146 are views illustrating an end tool of the surgical instrument for electrocautery ofFIG.140.FIG.147 is a perspective view illustrating an end tool hub of the surgical instrument for electrocautery ofFIG.140.FIGS.148 and149 are cut-away perspective views of the end tool hub ofFIG.147.FIGS.150 and151 are perspective views illustrating the end tool hub ofFIG.147.FIG.152 is a side view illustrating the end tool hub ofFIG.147 and a guide tube.FIG.153 is a plan view illustrating the end tool hub ofFIG.147 and the guide tube.FIG.154 is a perspective view illustrating an actuation hub of the surgical instrument for electrocautery ofFIG.140.FIG.155 is a cut-away perspective view of the actuation hub ofFIG.154.FIG.156 is an exploded perspective view illustrating the end tool of the surgical instrument for electrocautery ofFIG.140.FIG.157 is a perspective view illustrating a first jaw of the end tool of the surgical instrument for electrocautery ofFIG.140.FIG.158 is a perspective view illustrating a second jaw of the end tool of the surgical instrument for electrocautery ofFIG.140.FIG.159 is a perspective view illustrating a first jaw pulley of the surgical instrument for electrocautery ofFIG.140.FIG.160 is a plan view illustrating an opening and closing motion of the first jaw of the end tool of the surgical instrument for electrocautery ofFIG.140.FIG.161 is a plan view illustrating an opening and closing motion of the second jaw of the end tool of the surgical instrument for electrocautery ofFIG.140.FIG.162 is a plan view illustrating an opening and closing motion of the first jaw and the second jaw of the end tool of the surgical instrument for electrocautery ofFIG.140.

Referring toFIGS.140 to162 and the like, an electric cauterization surgical instrument10 according to the fourth embodiment of the present disclosure includes an end tool1100, a manipulation portion200, a power transmission portion300, and a connection portion400.

Here, the connection portion400 is formed in the shape of a hollow shaft, and one or more wires and electric wires may be accommodated therein. The manipulation portion200 is coupled to one end portion of the connection portion400, the end tool1100 is coupled to the other end portion thereof, and the connection portion400 may serve to connect the manipulation portion200 and the end tool1100. Here, the connection portion400 of the electric cauterization surgical instrument10 according to the fourth embodiment of the present disclosure includes a straight portion401 and a bent portion402, wherein the straight portion401 is formed at a side coupled to the end tool1100, and the bent portion402 is formed at a side to which the manipulation portion200 is coupled. As such, since the end portion of the connection portion400 at the side of the manipulation portion200 is formed to be bent, a pitch manipulation portion201, a yaw manipulation portion202, and an actuation manipulation portion203 may be formed along an extension line of the end tool1100 or adjacent to the extension line. In other words, it may be said that the pitch manipulation portion201 and the yaw manipulation portion202 are at least partially accommodated in a concave portion formed by the bent portion402. Due to the above-described shape of the bent portion402, the shapes and motions of the manipulation portion200 and the end tool1100 may be further intuitively matched with each other.

Meanwhile, a plane on which the bent portion402 is formed may be substantially the same as a pitch plane, that is, an XZ plane ofFIG.140. As such, as the bent portion402 is formed on substantially the same plane as the XZ plane, interference with the manipulation portion may be reduced. Of course, for intuitive motions of the end tool and the manipulation portion, any form other than the XZ plane may be possible.

Meanwhile, a connector410 may be formed on the bent portion402. The connector410 may be connected to an external power supply (not shown), and the connector410 may be connected to a jaw1103 through electric wires411 and412 to transfer electrical energy supplied from the external power supply (not shown) to the jaw1103. Here, the connector410 may be of a bipolar-type having two electrodes, or the connector410 may be of a monopolar type having one electrode.

The manipulation portion200 is formed at the one end portion of the connection portion400 and provided as an interface to be directly controlled by a medical doctor, for example, a tongs shape, a stick shape, a lever shape, or the like, and when the medical doctor controls the manipulation portion200, the end tool1100, which is connected to the interface and inserted into the body of a surgical patient, performs a certain motion, thereby performing surgery. Here, the manipulation portion200 is illustrated inFIG.140 as being formed in a handle shape that is rotatable while the finger is inserted therein, the concept of the present disclosure is not limited thereto, and various types of manipulation portions that are connected to the end tool1100 and manipulate the end tool1100 may be possible.

The end tool1100 is formed on the other end portion of the connection portion400, and performs necessary motions for surgery by being inserted into a surgical site. In an example of the end tool1100 described above, as shown inFIG.140, a pair of jaws1103 for performing a grip motion may be used. However, the concept of the present disclosure is not limited thereto, and various devices for performing surgery may be used as the end tool1100. For example, a configuration of a cantilever cautery may also be used as the end tool. The end tool1100 is connected to the manipulation portion200 by the power transmission portion300, and receives a driving force of the manipulation portion200 through the power transmission portion300 to perform a motion necessary for surgery, such as gripping, cutting, suturing, or the like.

Here, the end tool1100 of the electric cauterization surgical instrument10 according to the fourth embodiment of the present disclosure is formed to be rotatable in at least one direction, for example, the end tool1100 may perform a pitch motion around a Y-axis ofFIG.140 and simultaneously perform a yaw motion and an actuation motion around a Z-axis ofFIG.140.

The power transmission portion300 may connect the manipulation portion200 to the end tool1100, transmit the driving force of the manipulation portion200 to the end tool1100, and include a plurality of wires, pulleys, links, sections, gears, or the like.

The end tool1100, the manipulation portion200, the power transmission portion300, and the like of the electric cauterization surgical instrument10 ofFIG.140 will be described in detail later.

(Power Transmission Portion)

Hereinafter, the power transmission portion300 of the electric cauterization surgical instrument10 ofFIG.140 will be described in more detail.

Referring toFIGS.140 to146 and the like, the power transmission portion300 of the electric cauterization surgical instrument10 according to an embodiment of the present disclosure may include a wire301, a wire302, a wire303, a wire304, a wire305, a wire306, and a blade wire307.

Here, the wire301 and the wire305 may be paired to serve as first jaw wires. The wire302 and the wire306 may be paired to serve as second jaw wires. Here, the components encompassing the wires301 and305, which are first jaw wires, and the wires302 and306, which are second jaw wires, may be referred to as jaw wires. In addition, the wires303 and304 may be paired to serve as pitch wires.

In addition, the power transmission portion300 of the electric cauterization surgical instrument10 according to an embodiment of the present disclosure may include a fastening member321, a fastening member322, a fastening member323, a fastening member324, a fastening member326, and a fastening member327 that are coupled to respective end portions of the wires to respectively couple the wires and the pulleys. Here, each of the fastening members may have various shapes as necessary, such as a ball shape, a tube shape, and the like.

Here, at the end tool1100 side, the fastening member321/fastening member322 may serve as pitch wire-end tool fastening members, the fastening member323 may serve as a first jaw wire-end tool fastening member, and the fastening member326 may serve as a second jaw wire-end tool fastening member.

Further, at the manipulation portion200 side, the fastening member324 may serve as a first jaw wire-manipulation portion fastening member, and the fastening member327 may serve as a second jaw wire-manipulation portion fastening member. In addition, although not shown in the drawings, a pitch wire-manipulation portion fastening member and a blade wire-manipulation portion fastening member may be further formed at the manipulation portion200 side.

The coupling relationship between the wires, the fastening members, and the respectively pulleys will be described in detail as follows.

First, the wires301 and305, which are first jaw wires, may be a single wire. The fastening member323, which is a first jaw wire-end tool fastening member, is inserted at an intermediate point of the first jaw wire, which is a single wire, and the fastening member323 is crimped and fixed, and then, both strands of the first jaw wire centered on the fastening member323 may be referred to as the wire301 and the wire305, respectively.

Alternatively, the wires301 and305, which are first jaw wires, may also be formed as separate wires, and connected by the fastening member323.

In addition, by coupling the fastening member323 to a pulley1111, the wires301 and305 may be fixedly coupled to the pulley1111. This allows the pulley1111 to rotate as the wires301 and305 are pulled and released.

Meanwhile, the first jaw wire-manipulation portion fastening member324 may be coupled to the other end portions of the wires301 and305, which are opposite to one end portions to which the fastening member323 is fastened.

In addition, by coupling the first jaw wire-manipulation portion fastening member324 to a pulley211, the wires301 and305 may be fixedly coupled to the pulley211. As a result, when the pulley211 is rotated by a motor or human power, the wire301 and the wire305 are pulled and released, allowing the pulley1111 of the end tool1100 to rotate.

In the same manner, the wire302 and the wire306, which are second jaw wires, are coupled to each of the fastening member326, which is a second jaw wire-end tool fastening member, and the second jaw wire-manipulation portion fastening member327. In addition, the fastening member326 is coupled to a pulley1121, and the second jaw wire-manipulation portion fastening member is coupled to a pulley220. As a result, when the pulley220 is rotated by a motor or a human force, the pulley1121 of the end tool1100 may be rotated as the wire302 and the wire306 are pulled and released.

In the same manner, the wire304, which is a pitch wire, is coupled to the fastening member321, which is a pitch wire-end tool fastening member, and the pitch wire-manipulation portion fastening member (not shown). In addition, the wire303, which is a pitch wire, is coupled to a fastening member322, which is a pitch wire-end tool fastening member, and the pitch wire-manipulation portion fastening member (not shown).

In addition, the fastening member321 is coupled to a first pitch pulley portion1163aof an end tool hub1160, the fastening member322 is coupled to a second pitch pulley portion1163bof the end tool hub1160, and the pitch wire-manipulation portion fastening member (not shown) is coupled to a pulley231. As a result, when the pulley231 is rotated by a motor or human force, the wire303 and the wire304 are pulled and released, allowing the end tool hub1160 of the end tool1100 to rotate.

Meanwhile, one end portion of the blade wire307 is coupled to a blade1175 to be described later, and the other end portion thereof is coupled to a blade manipulation portion260 of the manipulation portion200. By the manipulation of the blade manipulation portion260, a cutting motion may be performed as the blade wire307 is moved from a proximal end1105 toward a distal end1104 of the end tool1100, or the blade wire307 may return from the distal end1104 toward the proximal end1105 of the end tool1100.

At this time, at least a part of the blade wire307 may be accommodated in a guide tube1170 to be described later. Accordingly, when the guide tube1170 is bent in response to a pitch motion or yaw motion of the end tool1100, the blade wire307 accommodated therein may also be bent together with the guide tube1170. The guide tube1170 will be described in more detail later.

In addition, the blade wire307 is formed in a longitudinal direction of the connection portion400 to be linearly movable in the connection portion400. In addition, since one end portion of the blade wire307 is coupled to the blade1175, when the blade wire307 is linearly moved in the longitudinal direction of the connection portion400, the blade1175 connected thereto is also linearly moved. That is, when the blade wire307 is linearly moved in the longitudinal direction of the connection portion400, a cutting motion is performed as the blade1175 connected thereto is moved toward the distal end1104 or the proximal end1105 of the end tool1100. This will be described in more detail later.

(End Tool)

Hereinafter, the end tool1100 of the electric cauterization surgical instrument10 ofFIG.140 will be described in more detail.

FIG.140 is a perspective view illustrating the surgical instrument for electrocautery according to the fourth embodiment of the present disclosure.FIGS.141 to146 are views illustrating the end tool of the surgical instrument for electrocautery ofFIG.140.

Here,FIG.141 illustrates a state in which the end tool hub1160 and a pitch hub1150 are coupled, andFIG.142 illustrates a state in which the end tool hub1160 and pitch hub1150 are removed.FIG.143 illustrates a state in which a first jaw1101 and a second jaw1102 are removed, andFIG.144 illustrates a state in which the first jaw1101, the second jaw1102, the pulley1111, the pulley1121, and the like are removed. Meanwhile,FIG.145 is a view mainly illustrating the wires, andFIG.146 is a view mainly illustrating the pulleys.

Referring toFIGS.140 to162 and the like, the end tool1100 of the fourth embodiment of the present disclosure includes a pair of jaws for performing a grip motion, that is, the first jaw1101 and a second jaw1102. Here, each of the first jaw1101 and the second jaw1102, or a component encompassing the first jaw1101 and the second jaw1102 may be referred to as the jaw1103.

Further, the end tool1100 may include the pulley1111, a pulley1113, a pulley1114, a pulley1115, and a pulley1116 associated with a rotational motion of the first jaw1101. In addition, the end tool1100 may include the pulley1121, a pulley1123, a pulley1124, a pulley1125, and a pulley1126, which are associated with a rotational motion of the second jaw1102.

Here, the pulleys facing each other are illustrated in the drawings as being formed parallel to each other, but the concept of the present disclosure is not limited thereto, and each of the pulleys may be variously formed with a position and a size suitable for the configuration of the end tool.

Further, the end tool1100 of the fourth embodiment of the present disclosure may include the end tool hub1160 and the pitch hub1150.

A first rotation shaft1141 to be described later may be inserted through the end tool hub1160, and the pulley1111 and the pulley1121 axially coupled to the first rotation shaft1141 and at least some of the first jaw1101 and the second jaw1102 coupled to the pulley1111 and the pulley1121 may be accommodated inside the end tool hub1160. Here, in an embodiment of the present disclosure, a wire guide portion1168 serving as an auxiliary pulley is formed in the end tool hub1160. That is, a first wire guide portion1168aand a second wire guide portion1168bfor guiding paths of the wire305 and the wire302 may be formed in the end tool hub1160. The wire guide portions1168 of the end tool hub1160 may serve as auxiliary pulleys (see612 and622 ofFIG.39) of the first embodiment and change the paths of the wires, and the first wire guide portion1168aand the second wire guide portion1168bof the end tool hub1160 serving as auxiliary pulleys will be described in more detail later.

Meanwhile, the first pitch pulley portion1163aand the second pitch pulley portion1163b, which serve as end tool pitch pulleys, may be formed at one end portion of the end tool hub1160. The wire303 and the wire304, which are pitch wires, are coupled to the first pitch pulley portion1163aand the second pitch pulley portion1163b, which serve as end tool pitch pulleys, and a pitch motion is performed while the end tool hub1160 rotates around a third rotation shaft1143.

The third rotation shaft1143 and a fourth rotation shaft1144 may be inserted through the pitch hub1150, and the pitch hub1150 may be axially coupled to the end tool hub1160 by the third rotation shaft1143. Accordingly, the end tool hub1160 may be formed to be pitch-rotatable around the third rotation shaft1143 with respect to the pitch hub1150.

Further, the pitch hub1150 may internally accommodate at least some of the pulley1113, the pulley1114, the pulley1123, and the pulley1124 that are axially coupled to the third rotation shaft1143. Further, the pitch hub1150 may internally accommodate at least some of the pulley1115, the pulley1116, the pulley1125, and the pulley1126 that are axially coupled to the fourth rotation shaft1144.

One end portion of the pitch hub1150 is connected to the end tool hub1160, and the other end portion of the pitch hub1150 is connected to the connection portion400.

Here, the end tool1100 of the fourth embodiment of the present disclosure may include the first rotation shaft1141, the third rotation shaft1143, and the fourth rotation shaft1144. As described above, the first rotation shaft1141 may be inserted through the end tool hub1160, and the third rotation shaft1143 and the fourth rotation shaft1144 may be inserted through the pitch hub1150.

The first rotation shaft1141, the third rotation shaft1143, and the fourth rotation shaft1144 may be arranged sequentially from the distal end1104 toward the proximal end1105 of the end tool1100. Accordingly, starting from the distal end1104, the first rotation shaft1141 may be referred to as a first pin, the third rotation shaft1143 may be referred to as a third pin, and the fourth rotation shaft1144 may be referred to as a fourth pin.

Here, the first rotation shaft1141 may function as an end tool jaw pulley rotation shaft, the third rotation shaft1143 may function as an end tool pitch rotation shaft, and the fourth rotation shaft1144 may function as an end tool pitch auxiliary rotation shaft of the end tool1100.

Here, each of the rotation shafts may include two shafts of a first sub-shaft and a second sub-shaft. Alternatively, it may be said that each of the rotation shafts is formed by being divided into two parts.

For example, the first rotation shaft1141 may include two shafts of a first sub-shaft1141aand a second sub-shaft1141b. In addition, the third rotation shaft1143 may include two shafts of a first sub-shaft1143aand a second sub-shaft1143b. The fourth rotation shaft1144 may include two shafts of a first sub-shaft and a second sub-shaft.

Each of the rotation shafts is formed by being divided into two parts as described above to allow the guide tube1170 to be described later to pass through the end tool hub1160 and the pitch hub1150. That is, the guide tube1170 may pass between the first sub-shaft and the second sub-shaft of each of the rotation shafts. This will be described in more detail later. Here, the first sub-shaft and the second sub-shaft may be disposed on the same axis or may be disposed to be offset to a certain degree.

Meanwhile, it is illustrated in the drawings that each of the rotation shafts is formed by being divided into two parts, but the concept of the present disclosure is not limited thereto. That is, each of the rotation shafts is formed to be curved in the middle such that an escape path for the guide tube1170 is formed.

Each of the rotation shafts1141,1143, and1144 may be fitted into one or more pulleys, which will be described in detail below.

Meanwhile, the end tool1100 may further include an actuation rotation shaft1145. In detail, the first jaw1101 and the second jaw1102 may be axially coupled by the actuation rotation shaft1145, and in this state, an actuation motion may be performed while the first jaw1101 and the second jaw1102 rotate around the actuation rotation shaft1145. Here, the actuation rotation shaft1145 may be disposed closer to the distal end1104 than the first rotation shaft1141 is.

Here, in the end tool1100 of the fourth embodiment of the present disclosure, the first rotation shaft1141, which is a yaw rotation shaft, and the actuation rotation shaft1145 are provided separately rather than as the same shaft. That is, by forming the first rotation shaft1141, which is a rotation shaft of the pulley1111/pulley1121 that are jaw pulleys and a rotation shaft of a yaw motion, and the actuation rotation shaft1145, which is a rotation shaft of the second jaw1102 with respect to the first jaw1101 and a rotation shaft of an actuation motion, to be spaced apart from each other by a certain distance, a space in which the guide tube1170 and the blade wire307 accommodated therein can be gently bent may be secured. The actuation rotation shaft1145 will be described in detail later.

The pulley1111 functions as an end tool first jaw pulley, and the pulley1121 functions as an end tool second jaw pulley. The pulley1111 may also be referred to as a first jaw pulley, and the pulley1121 may also be referred to as a second jaw pulley, and these two components may collectively be referred to as end tool jaw pulleys or simply jaw pulleys.

The pulley1111 and the pulley1121, which are end tool jaw pulleys, are formed to face each other, and are formed to be rotatable independently of each other around the first rotation shaft1141 which is an end tool jaw pulley rotation shaft. In this case, the pulley1111 and pulley1121 are formed to be spaced apart by a certain distance, and a blade assembly accommodation portion may be accommodated therebetween. In addition, at least a part of a blade assembly to be described later may be disposed in the blade assembly accommodation portion. In other words, the blade assembly including the guide tube1170 may be disposed between the pulley1111 and the pulley1121.

Here, since the pulley1111 is connected to the first jaw1101, when the pulley1111 rotates around the first rotation shaft1141, the first jaw1101 may also rotate around the first rotation shaft1141 together with the pulley1111.

Meanwhile, since the pulley1121 is connected to the second jaw1102, when the pulley1121 rotates around the first rotation shaft1141, the second jaw1102 connected to the pulley1121 may rotate around the first rotation shaft1141.

In addition, a yaw motion and an actuation motion of the end tool1100 are performed in response to the rotation of the pulley1111 and the pulley1121. That is, when the pulley1111 and the pulley1121 rotate in the same direction around the first rotation shaft1141, the yaw motion is performed as the first jaw1101 and the second jaw1102 rotate with the first rotation shaft1141 as the center of rotation. Meanwhile, when the pulley1111 and the pulley1121 rotate in opposite directions around the first rotation shaft1141, the actuation motion is performed as the first jaw1101 and the second jaw1102 rotate around the actuation rotation shaft1145.

The pulley1113 and the pulley1114 function as end tool first jaw pitch main pulleys, and the pulley1123 and the pulley1124 function as end tool second jaw pitch main pulleys, and these two components may collectively be referred to as end tool jaw pitch main pulleys.

The pulley1115 and the pulley1116 function as end tool first jaw pitch sub-pulleys, and the pulley1125 and the pulley1126 function as end tool second jaw pitch sub-pulleys, and these two components collectively may be referred to as end tool jaw pitch sub-pulleys.

Hereinafter, components associated with the rotation of the pulley1111 will be described.

The pulley1113 and the pulley1114 function as end tool first jaw pitch main pulleys. That is, the pulley1113 and the pulley1114 function as main rotation pulleys for a pitch motion of the first jaw1101. Here, the wire301, which is a first jaw wire, is wound around the pulley1113, and the wire305, which is a first jaw wire, is wound around the pulley1114.

The pulley1115 and the pulley1116 function as end tool first jaw pitch sub-pulleys. That is, the pulley1115 and the pulley1116 function as sub-rotation pulleys for a pitch motion of the first jaw1101. Here, the wire301, which is a first jaw wire, is wound around the pulley1115, and the wire305, which is a first jaw wire, is wound around the pulley1116.

Here, the pulley1113 and the pulley1114 are disposed on one side of the pulley1111 to face each other. Here, the pulley1113 and the pulley1114 are formed to be rotatable independently of each other around the third rotation shaft1143 that is an end tool pitch rotation shaft. In addition, the pulley1115 and the pulley1116 are disposed on one side of the pulley1113 and one side of the pulley1114, respectively, to face each other. Here, the pulley1115 and the pulley1116 are formed to be rotatable independently of each other around the fourth rotation shaft1144 that is an end tool pitch auxiliary rotation shaft. Here, in the drawings, it is illustrated that the pulley1113, the pulley1115, the pulley1114, and the pulley1116 are all formed to be rotatable around a Y-axis direction, but the concept of the present disclosure is not limited thereto, and the rotation axes of the respective pulleys may be formed in various directions according to configurations thereof.

The wire301, which is a first jaw wire, is sequentially wound to make contact with at least portions of the pulley1115, the pulley1113, and the pulley1111. In addition, the wire305 connected to the wire301 by the fastening member323 is sequentially wound to make contact with at least portions of the pulley1111, the first wire guide portion1168aof the end tool hub1160, the pulley1114, and the pulley1116.

In other words, the wire301 and the wire305, which are the first jaw wire, are sequentially wound to make contact with at least portions of the pulley1115, the pulley1113, the pulley1111, the first wire guide portion1168aof the end tool hub1160, the pulley1114, and the pulley1116, and the wire301 and the wire305 formed to move along the above pulleys while rotating the above pulleys.

Accordingly, when the wire301 is pulled in the direction of an arrow301 ofFIG.145, the fastening member323 to which the wire301 is coupled and the pulley1111 coupled to the fastening member323 are rotated in the counterclockwise direction. On the contrary, when the wire305 is pulled in the direction of an arrow305 ofFIG.145, the fastening member323 to which the wire305 is coupled and the pulley1111 coupled to the fastening member323 are rotated in the clockwise direction in theFIG.145.

Next, components associated with the rotation of the pulley1121 will be described.

The pulley1123 and the pulley1124 function as end tool second jaw pitch main pulleys. That is, the pulley1123 and the pulley1124 function as main rotation pulleys for a pitch motion of the second jaw1102. Here, the wire306, which is a second jaw wire, is wound around the pulley1123, and the wire302, which is a second jaw wire, is wound around the pulley1124.

The pulley1125 and the pulley1126 function as end tool second jaw pitch sub-pulleys. That is, the pulley1125 and the pulley1126 function as sub-rotation pulleys for a pitch motion of the second jaw1102. Here, the wire306, which is a second jaw wire, is wound around the pulley1125, and the wire302, which is a second jaw wire, is wound around the pulley1126.

Here, the pulley1123 and the pulley1124 are disposed on one side of the pulley1121 to face each other. Here, the pulley1123 and the pulley1124 are formed to be rotatable independently of each other around the third rotation shaft1143 that is an end tool pitch rotation shaft. In addition, the pulley1125 and the pulley1126 are disposed on one side of the pulley1123 and one side of the pulley1124, respectively, to face each other. Here, the pulley1125 and the pulley1126 are formed to be rotatable independently of each other around the fourth rotation shaft1144 that is an end tool pitch auxiliary rotation shaft. Here, in the drawings, it is illustrated that all of the pulley1123, the pulley1125, the pulley1124, and the pulley1126 are formed to be rotatable around the Y-axis direction, but the concept of the present disclosure is not limited thereto, and the rotating axes of the respective pulleys may be formed in various directions according to configurations thereof.

The wire306, which is a second jaw wire, is sequentially wound to make contact with at least portions of the pulley1125, the pulley1123, and the pulley1121. In addition, the wire302 connected to the wire306 by the fastening member326 is sequentially wound to make contact with at least portions of the pulley1121, the second wire guide portion1168bof the end tool hub1160, the pulley1124, and the pulley1126.

In other words, the wire306 and the wire302, which are the second jaw wire, are sequentially wound to make contact with at least portions of the pulley1125, the pulley1123, the pulley1121, the second wire guide portion1168bof the end tool hub1160, the pulley1124, and the pulley1126, and the wire306 and the wire302 are formed to move along the above pulleys while rotating the above pulleys.

Accordingly, when the wire306 is pulled in the direction of an arrow306 ofFIG.145, the fastening member326 to which the wire306 is coupled and the pulley1121 coupled to the fastening member326 are rotated in the clockwise direction inFIG.145. On the contrary, when the wire302 is pulled toward the arrow302 ofFIG.145, the fastening member326 coupled to the wire302 and the pulley1121 coupled to the fastening member326 may rotate in the counterclockwise direction inFIG.145.

Hereinafter, a pitch motion of the present disclosure will be described in more detail.

Meanwhile, when the wire301 is pulled in the direction of the arrow301 ofFIG.145, and simultaneously, the wire305 is pulled in the direction of the arrow305 ofFIG.145 (that is, when both strands of the first jaw wire are pulled), as shown inFIG.144, since the wires301 and305 are wound around lower portions of the pulley1113 and the pulley1114 rotatable around the third rotation shaft1143, which is an end tool pitch rotation shaft, the pulley1111 to which the wires301 and305 are fixedly coupled and the end tool hub1160 to which the pulley1111 is coupled rotate as a whole in the counterclockwise direction around the third rotation shaft1143, and as a result, the end tool1100 may rotate downward to perform the pitch motion. At this time, since the second jaw1102 and the wires302 and306 fixedly coupled thereto are wound around upper portions of the pulley1123 and the pulley1124 rotatable around the third rotation shaft1143, the wires302 and306 are released in the opposite directions of the arrows302 and306, respectively.

On the contrary, when the wire302 is pulled in the direction of the arrow302 ofFIG.145, and simultaneously, the wire306 is pulled in the direction of the arrow306 ofFIG.145, as shown inFIG.144, since the wires302 and306 are wound around the upper portions of the pulley1123 and the pulley1124 rotatable around the third rotation shaft1143, which is an end tool pitch rotation shaft, the pulley1121 to which the wires302 and306 are fixedly coupled and the end tool hub1160 to which the pulley1121 is coupled rotate as a whole in the clockwise direction around the third rotation shaft1143, and as a result, the end tool1100 may rotate upward to perform the pitch motion. At this time, since the first jaw1101 and the wires301 and305 fixedly coupled thereto are wound around lower portions of the pulley1113 and the pulley1114 rotatable around the third rotation shaft1143, the wires302 and306 are moved in the opposite directions of the arrows301 and305, respectively.

Meanwhile, the end tool hub1160 of the end tool1100 of the electric cauterization surgical instrument10 of the present disclosure may further include the first pitch pulley portion1163aand the second pitch pulley portion1163bserving as end tool pitch pulleys, the manipulation portion200 may further include the pulley231 and a pulley232, which are manipulation portion pitch pulleys, and the power transmission portion300 may further include the wire303 and the wire304 which are pitch wires.

In detail, the end tool hub1160 including the first pitch pulley portion1163aand the second pitch pulley portion1163bmay be formed to be rotatable around the third rotation shaft1143 that is an end tool pitch rotation shaft. In addition, the wires303 and304 may serve to connect the first and second pitch pulley portions1163aand1163bof the end tool1100 and the pulleys231 and232 of the manipulation portion200.

Thus, when the pulleys231 and232 of the manipulation portion200 rotate, the rotation of the pulleys231 and232 is transmitted to the end tool hub1160 of the end tool1100 through the wires303 and304, causing the end tool hub1160 to rotate as well, and as a result, the end tool1100 performs a pitch motion while rotating.

That is, the electric cauterization surgical instrument10 according to the fourth embodiment of the present disclosure includes the first and second pitch pulley portions1163aand1163bof the end tool1100, the pulleys231 and232 of the manipulation portion200, and the wires303 and304 of the power transmission portion300 in order to transmit driving force for a pitch motion, and thus, the driving force for the pitch motion of the manipulation portion200 is more completely transmitted to the end tool1100, thereby improving operation reliability.

(Blade Wire and Guide Tube)

Hereinafter, the blade wire307 and the guide tube1170 of the present disclosure will be described in more detail.

The guide tube1170 according to the present disclosure is formed to surround the blade wire307 in a certain section, and at this time, the blade wire307 is movable inside the guide tube1170. In other words, in a state in which in which the blade wire307 is inserted into the guide tube1170, the blade wire307 is movable relative to the guide tube1170.

Here, the guide tube1170 serves to guide the path of the blade wire307 by preventing the blade wire307 from being curved in an unintended direction when the blade wire307 is pushed or pulled. A cutting motion may be smoothly performed by the guide tube1170.

Meanwhile, one end portion of the guide tube1170 may be fixedly coupled to an actuation hub1190 to be described later. Here, the actuation hub1190 may serve as a first coupling portion. In addition, the other end portion of the guide tube1170 may be fixedly coupled to a second coupling portion (not shown) in the connection portion400. Since both end portions of the guide tube1170 are fixedly coupled to certain points (the first coupling portion and the second coupling portion) as described above, respectively, the entire length of the guide tube1170 may remain constant. Accordingly, the length of the blade wire307 inserted into the guide tube1170 may also remain constant.

Meanwhile, the guide tube1170 according to the present disclosure may be formed of a flexible material and formed to be bendable. Accordingly, when the end tool1100 performs a yaw motion around the first rotation shaft1141 or a pitch motion around the third rotation shaft1143, the guide tube1170 may be bent while being deformed in shape corresponding thereto. In addition, when the guide tube1170 is bent, the blade wire307 placed thereinside is also bent.

Here, although the length of the guide tube1170 is constant, the relative position and distance of the first coupling portion (i.e., the actuation hub1190) and the second coupling portion (not shown) may be changed as the end tool1100 is pitch-rotated or yaw-rotated, and thus a space for the guide tube1170 to move by the changed distance is required. To this end, a pitch slit1164 and a yaw slit1165 may be provided in the end tool hub1160 to form spaces for movement of the guide tube1170. Such a configuration of the end tool hub1160 will be described in detail later.

Meanwhile, as described above, the blade wire307 is inserted through the guide tube1170, and the blade wire307 is relatively movable inside the guide tube1170 with respect to the guide tube1170. That is, when the blade wire307 is pulled in a state in which the guide tube1170 is fixed, the blade1175 connected to the blade wire307 is moved toward the proximal end1105, and when the blade wire307 is pushed, the blade1175 connected to the blade wire307 is moved toward the distal end1104.

This will be described below in more detail.

The most reliable way to perform a cutting motion using the blade1175 is by pushing and pulling the blade1175 with the blade wire307. In addition, in order for the blade wire307 to push and pull the blade1175, the guide tube1170 that can guide the path of the blade wire307 should be provided. When the guide tube1170 does not guide the path of the blade wire307 (i.e., does not hold the blade wire307), a phenomenon may occur in which cutting is not performed and a middle portion of the blade wire307 is curved even when the blade wire307 is pushed. Accordingly, in order to reliably perform the cutting motion using the blade1175, the blade wire307 and the guide tube1170 should be essentially included.

However, when the blade wire307 is used to drive a cutting motion, the cutting should be performed while pushing the blade wire307, and in this case, in order for the blade wire307 to receive a force, a relatively stiff (i.e., non-bendable) wire should be used for the blade wire307. However, the stiff (i.e., non-bendable) wire may have a small bendable range and may be permanently deformed when a force equal to or greater than a certain degree is applied.

In other words, in the case of a stiff (i.e., non-bendable) wire, there is a minimum radius of curvature that may be bent and spread without permanent deformation. In other words, when the wire or the guide tube is curved below a specific radius of curvature, both the wire and the guide tube may undergo permanent deformation while being bent, thereby restricting the capacity to perform cutting while moving backward and forward. Thus, it is necessary to keep the blade wire307 curved while having a gentle curvature.

Thus, in order to prevent the blade wire307 from being rapidly bent while passing through the pulleys, a space, in which the blade wire307 can be gently bent, is required between the jaw1103 (i.e., the actuation rotation shaft1145) and the end tool hub1160 (i.e., the first rotation shaft1141 that is a yaw shaft).

To this end, according to the present disclosure, the first rotation shaft1141, which is a yaw rotation shaft, and the actuation rotation shaft1145 are separately provided, and the first rotation shaft1141 and the actuation rotation shaft1145 are spaced apart from each other by a certain distance, thereby forming a space in which the blade wire307 and the guide tube1170 can be gently bent.

As described above, since the blade wire307 and the guide tube1170 need to be connected to the blade1175 through the end tool hub1160, and a space in which the blade wire307 and the guide tube1170 can be bent in the end tool hub1160 is necessary, in the present disclosure, 1) spaces, through which the blade wire307/the guide tube1170 can pass and simultaneously are bendable, that is, the pitch slit1164 and the yaw slit1165, are formed in the end tool hub1160, 2) each of the rotation shafts is formed by being divided into two parts, and 3) a pitch round portion1166 and a yaw round portion1167 are additionally formed to guide the bending of the blade wire307 and the guide tube1170.

In other words, when one end portion of the guide tube1170 is fixed in the connection portion400, and the other end portion thereof is moved while performing pitch and yaw motions, the guide tube1170 is curved in a direction, in which the gentlest curvature (hereinafter, referred to as “maximum gentle curvature”) can be achieved in response to a change in a distance between both end portions thereof. As such, by achieving the maximum gentle curvature of the natural state, the motion of the blade wire307 is smooth and the permanent deformation does not occur.

Thus, in order to secure the maximum gentle curvature, the pitch slit1164 and the yaw slit1165 are formed on the path of the guide tube1170, and furthermore, the pitch round portion1166 and the yaw round portion1167 may be additionally formed in the end tool hub1160. Accordingly, the guide tube1170 may have such a shape that is the most similar to the maximum gentle curvature (although not having the maximum gentle curvature).

Hereinafter, the end tool hub1160 will be described in more detail.

(End Tool Hub)

FIG.147 is a perspective view illustrating the end tool hub of the surgical instrument for electrocautery ofFIG.140.FIGS.148 and149 are cut-away perspective views of the end tool hub ofFIG.147.FIGS.150 and151 are perspective views illustrating the end tool hub ofFIG.147.FIG.152 is a side view illustrating the end tool hub ofFIG.147 and the guide tube.FIG.153 is a plan view illustrating the end tool hub ofFIG.147 and the guide tube.

Referring toFIGS.147 to153, the end tool hub1160 includes a body portion1161, a first jaw pulley coupling portion1162a, a second jaw pulley coupling portion1162b, the first pitch pulley portion1163a, the second pitch pulley portion1163b, the pitch slit1164, the yaw slit1165, the pitch round portion1166, the yaw round portion1167, and the wire guide portion1168. In addition, the wire guide portion1168 includes the first wire guide portion1168aand the second wire guide portion1168b.

The first jaw pulley coupling portion1162aand the second jaw pulley coupling portion1162bmay be formed in the end tool hub1160 at the distal end side. Here, the first jaw pulley coupling portion1162aand the second jaw pulley coupling portion1162bare formed to face each other, and the pulley1111 and the pulley1121 are accommodated therein. Here, the first jaw pulley coupling portion1162aand the second jaw pulley coupling portion1162bmay be formed to be approximately parallel to a plane perpendicular to the first rotation shaft1141 that is a yaw rotation shaft.

The first jaw pulley coupling portion1162aand the second jaw pulley coupling portion1162bare connected by the body portion1161. That is, the first jaw pulley coupling portion1162aand the second jaw pulley coupling portion1162b, which are parallel to each other, are coupled by the body portion1161 formed in a direction approximately perpendicular to the first jaw pulley coupling portion1162aand the second jaw pulley coupling portion1162b, so that the first jaw pulley coupling portion1162a, the second jaw pulley coupling portion1162b, and the body portion1161 form an approximately U-shape, in which the pulley1111 and the pulley1121 are accommodated.

In other words, it may be said that the first jaw pulley coupling portion1162aand the second jaw pulley coupling portion1162bare formed to extend in the X-axis direction from the body portion1161.

Here, the pulley1111, which is a first jaw pulley, is disposed close to the first jaw pulley coupling portion1162aof the end tool hub1160, and the pulley1121, which is a second jaw pulley, is disposed close to the second jaw pulley coupling portion1162bof the end tool hub1160, and thus the yaw slit1165 may be formed between the first jaw pulley coupling portion1162aand the second jaw pulley coupling portion1162b. In addition, at least a part of the blade assembly to be described later may be disposed in the yaw slit1165. In other words, it may be said that at least a part of the guide tube1170 of the blade assembly may be disposed between the first jaw pulley coupling portion1162aand the second jaw pulley coupling portion1162b. As such, by disposing the blade assembly including the guide tube1170 between the pulley1111, which is a first jaw pulley, and the pulley1121, which is a second jaw pulley, the end tool1100 is able to perform the cutting motion using the blade1175 in addition to the pitch and yaw motions. This will be described in more detail later.

Meanwhile, a through hole is formed in the first jaw pulley coupling portion1162asuch that the first rotation shaft1141 passes through the first jaw pulley coupling portion1162aand the pulley1111 and axially couples the first jaw pulley coupling portion1162aand the pulley1111. In addition, a through hole is formed in the second jaw pulley coupling portion1162bsuch that the first rotation shaft1141 passes through the second jaw pulley coupling portion1162band the pulley1121 and axially couples the second jaw pulley coupling portion1162band the pulley1121.

Here, as described above, the first rotation shaft1141, which is a yaw rotation shaft, may be formed by being divided into two parts of the first sub-shaft1141aand the second sub-shaft1141b, and the guide tube1170 may pass between the first sub-shaft1141aand the second sub-shaft1141bof the first rotation shaft1141.

In addition, the yaw slit1165 may be formed between the first jaw pulley coupling portion1162aand the second jaw pulley coupling portion1162b. Since the yaw slit1165 is formed in the end tool hub1160 as described above, the guide tube1170 may pass through the inside of the end tool hub1160.

In other words, the first rotation shaft1141 is vertically separated into two parts without passing through the end tool hub1160, and the yaw slit1165 may be formed on a plane perpendicular to the first rotation shaft1141 in the vicinity of the first rotation shaft1141. Accordingly, the guide tube1170 is movable (i.e., movable left and right) in the yaw slit1165 while passing through the vicinity of the first rotation shaft1141.

Meanwhile, the yaw round portion1167 may be further formed in the body portion1161. The yaw round portion1167 may be formed to be rounded so as to have a predetermined curvature. In detail, when viewed from a plane perpendicular to the first rotation shaft1141 that is a yaw rotation shaft, the yaw round portion1167 may be formed to be rounded so as to have a predetermined curvature. For example, the yaw round portion1167 may be formed in a fan shape, and may be formed along a path in which the guide tube1170 is bent on an XY plane. The yaw round portion1167 as described above may serve to guide the path of the guide tube1170 when the end tool1100 yaw-rotates.

The wire guide portion1168, which guides a path of the wire passing through the inside of the end tool hub1160, is formed at one side of the body portion1161. Here, the wire guide portion1168 includes the first wire guide portion1168aand the second wire guide portion1168b. Here, the first wire guide portion1168amay be formed on an inner side surface of the first jaw pulley coupling portion1162a. In addition, the second wire guide portion1168bmay be formed on an inner side surface of the second jaw pulley coupling portion1162b.

Here, the wire guide portion1168 may be formed in a cylindrical shape with a cross section that is approximately semi-circular. In addition, the semi-circular portion may be disposed to protrude toward the pulley1111 and the pulley1121. In other words, it may be said that the wire guide portion1168 is formed to protrude toward a space formed by the first jaw pulley coupling portion1162a, the second jaw pulley coupling portion1162b, and the body portion1161. In other words, it may be said that, in the wire guide portion1168, a region adjacent to the first jaw pulley coupling portion1162aand the second jaw pulley coupling portion1162bis formed to have a cross section that is curved with a predetermined curvature.

Alternatively, in other words, it may be also said that the wire guide portion1168 functions as a kind of pulley member, which guides the paths of the wire305 and the wire302 by winding the wire305 and the wire302 around an outer circumferential surface thereof. However, here, the wire guide portion1168 is not a member that rotates around a certain shaft as the original meaning pulley does, and it may be said that the wire guide portion1168 is formed to be fixed as a portion of the end tool hub1160 and performs some similar functions of a pulley by winding a wire therearound.

Here, the wire guide portion1168 is illustrated in the drawing as being formed in a cylindrical shape with a cross section that is approximately semi-circular. That is, at least a part of the cross section of the wire guide portion1168 on the XY plane is illustrated as having a certain arc shape. However, the concept of the present disclosure is not limited thereto, and the cross section may have a predetermined curvature like an oval or a parabola, or a corner of a polygonal column is rounded to a certain degree, so that the cross section may have various shapes and sizes suitable for guiding the paths of the wire305 and the wire302.

Here, a guide groove for guiding the paths of the wire305 and the wire302 well may be further formed in a portion of the wire guide portion1168, which is in contact with the wire305 and the wire302. The guide groove may be formed in the form of a groove recessed to a certain degree from a protruding surface of the wire guide portion1168.

Here, although the guide groove is illustrated in the drawing as being formed in the entire arc surface of the wire guide portion1168, the concept of the present disclosure is not limited thereto, and the guide groove may be formed only in a portion of the arc surface of the wire guide portion1168 as necessary.

As described above, by further forming the guide groove in the wire guide portion1168, unnecessary friction between the wires is reduced, so that durability of the wires may be improved.

The first pitch pulley portion1163aand the second pitch pulley portion1163b, which serve as end tool pitch pulleys, may be formed on the end tool hub1160 at the proximal end side. Here, the first pitch pulley portion1163aand the second pitch pulley portion1163bmay be formed to face each other. Here, the first pitch pulley portion1163aand the second pitch pulley portion1163bmay be formed to be approximately parallel to a plane perpendicular to the third rotation shaft1143, which is a pitch rotation shaft.

In detail, one end portion of the end tool hub1160 is formed in a disk shape similar to a pulley, and grooves around which a wire may be wound may be formed on an outer circumferential surface of the one end portion, thereby forming the first pitch pulley portion1163aand the second pitch pulley portion1163bThe wire303 and the wire304 described above are coupled to the first pitch pulley portion1163aand the second pitch pulley portion1163b, which serve as end tool pitch pulleys, and a pitch motion is performed while the end tool hub1160 rotates around the third rotation shaft1143.

Meanwhile, although not shown in the drawings, the pitch pulley may be formed as a separate member from the end tool hub1160 and coupled to the end tool hub1160.

The first pitch pulley portion1163aand the second pitch pulley portion1163bmay be connected by the body portion1161. That is, the first pitch pulley portion1163aand the second pitch pulley portion1163b, which are parallel to each other, are coupled by the body portion1161 formed in a direction approximately perpendicular to the first pitch pulley portion1163aand the second pitch pulley portion1163b, and thus the first pitch pulley portion1163a, the second pitch pulley portion1163b, and the body portion1161 may form an approximately U-shape.

In other words, it may be said that the first pitch pulley portion1163aand the second pitch pulley portion1163bare formed to extend from the body portion1161 in the X-axis direction.

Meanwhile, a through hole is formed in the first pitch pulley portion1163aso that the third rotation shaft1143 may pass through the first pitch pulley portion1163a. In addition, a through hole is formed in the second pitch pulley portion1163bso that the third rotation shaft1143 may pass through the second pitch pulley portion1163b.

In this case, as described above, the third rotation shaft1143, which is a pitch rotation shaft, may be formed by being divided into two parts of the first sub-shaft1143aand the second sub-shaft1143b, and the guide tube1170 may pass between the first sub-shaft1143aand the second sub-shaft1143bof the third rotation shaft1143.

The pitch slit1164 may be formed between the first pitch pulley portion1163aand the second pitch pulley portion1163b. Since the pitch slit1164 is formed in the end tool hub1160 as described above, the guide tube1170 may pass through the inside of the end tool hub1160.

In other words, the third rotation shaft1143 is horizontally separated into two parts without passing through the end tool hub1160, and the pitch slit1164 may be formed on a plane perpendicular to the third rotation shaft1143 in the vicinity of the third rotation shaft1143. Accordingly, the guide tube1170 is movable (movable up and down) in the pitch slit1164 while passing through the vicinity of the third rotation shaft1143.

Meanwhile, the pitch round portion1166 may be further formed in the body portion1161. The pitch round portion1166 may be formed to be rounded to have a predetermined curvature. In detail, when viewed from a plane perpendicular to the third rotation shaft1143, which is a pitch rotation shaft, the pitch round portion1166 may be formed to be rounded to have a predetermined curvature. For example, the pitch round portion1166 may be formed in a fan shape, and formed along a path in which the guide tube1170 is bent on the XZ plane. The pitch round portion1166 as described above may serve to guide the path of the guide tube1170 when the end tool1100 pitch-rotates.

Here, the pitch slit1164 and the yaw slit1165 may be formed to be connected to each other. Accordingly, the guide tube1170 and the blade wire307 located therein may be disposed to completely pass through the inside of the end tool hub1160. In addition, the blade1175 coupled to one end portion of the blade wire307 may linearly reciprocate inside the first jaw1101 and the second jaw1102.

As described above, since the blade wire307 and the guide tube1170 need to be connected to the blade1175 through the end tool hub1160, and a space in which the blade wire307 and the guide tube1170 can be bent in the end tool hub1160 is necessary, in the present disclosure, 1) spaces, through which the blade wire307/the guide tube1170 can pass and simultaneously are bendable, that is, the pitch slit1164 and the yaw slit1165, are formed in the end tool hub1160,2) the rotation shafts are formed by being divided into two parts, and 3) the pitch round portion1166 and the yaw round portion1167 are additionally formed to guide the bending of the blade wire307/the guide tube1170.

Hereinafter, the role and function of the wire guide portion1168 will be described in more detail.

The wire guide portion1168 may be in contact with the wire305 and the wire302 and may change the arrangement path of the wire305 and the wire302 to a certain degree to serve to increase a rotation radius of each of the first jaw1101 and the second jaw1102.

That is, when the auxiliary pulleys are not disposed, each of the pulley1111, which is a first jaw pulley, and the pulley1121, which is a second jaw pulley, may rotate up to a right angle, but in the fourth embodiment of the present disclosure, by additionally providing the wire guide portion1168 in the end tool hub1160, the maximum rotation angle of each pulley may be increased.

This enables a motion in which two jaws of the end tool1100 have to be spread apart for an actuation motion in a state in which the two jaws are yaw-rotated together by 90°. In other words, the range of yaw rotation in which an actuation motion is possible may be increased through the configuration of the wire guide portion1168 of the end tool hub1160. In other words, the range of yaw rotation in which an actuation motion is possible may be increased through the configuration of the wire guide portion1168 of the end tool hub1160.

Furthermore, by forming the wire guide portion1168 in the end tool hub1160, which already exists, without adding a separate structure such as an auxiliary pulley, the range of rotation may be increased without adding a component and a manufacturing process.

As described above, since there is no need to additionally dispose a separate structure for increasing the rotation angle, the number of components is decreased and the manufacturing process is simplified, and also, the length of the end tool is shortened by as much as the size of the auxiliary pulley, so that the length of the end tool is shortened during a pitch motion. Accordingly, a surgical motion may be more easily performed in a narrow space.

This will be described below in more detail.

In the end tool1100 of the surgical instrument according to the fourth embodiment of the present disclosure, the arrangement path of the wires may be changed without a separate structure by forming the wire guide portion1168 capable of changing the path of the wire on an inner side wall of the end tool hub1160. As described above, as the arrangement path of the wire305 and the wire302 is changed to a certain degree by forming the wire guide portion1168 in the end tool hub1160, a tangential direction of the wire305 and the wire302 is changed, and accordingly, rotation angles of the fastening member323 and the fastening member326 that couple respective wires and pulleys may be increased.

That is, the fastening member326 that couples the wire302 and the pulley1121 is rotatable until being located on a common internal tangent of the pulley1121 and the wire guide portion1168. Similarly, the fastening member (see323 ofFIG.6) that couples the wire305 and the pulley1111 is rotatable until being located on a common internal tangent of the pulley1111 and the wire guide portion1168, so that a rotation angle of the fastening member (see323 ofFIG.6) may be increased.

In other words, the wire301 and the wire305 wound around the pulley1111 by the wire guide portion1168 are disposed on one side with respect to a plane perpendicular to the Y-axis and passing through the X-axis. Simultaneously, the wire302 and the wire306 wound around the pulley1121 by the wire guide portion1168 are disposed on the other side with respect to the plane perpendicular to the Y-axis and passing through the X-axis.

In other words, the pulley1113 and the pulley1114 are disposed at one side with respect to the plane perpendicular to the Y-axis and passing through the X-axis, and the pulley1123 and the pulley1124 are disposed at the other side with respect to the plane perpendicular to the Y-axis and passing through the X-axis.

In other words, the wire305 is located on the internal tangent of the pulley1111 and the wire guide portion1168, and a rotation angle of the pulley1111 is increased due to the wire guide portion1168. In addition, the wire302 is located on the internal tangent of the pulley1121 and the wire guide portion1168, and the rotation angle of the pulley1121 is increased due to the wire guide portion1168.

In the present embodiment in which an auxiliary pulley is not formed and the wire guide portion1168 capable of changing the path of a wire is formed on the inner side wall of the end tool hub1160, the length of the end tool of the surgical instrument may be shortened as compared to the surgical instrument of the first embodiment in which a separate auxiliary pulley is formed. Since the length of the end tool is shortened as described above, a surgical operator may easily manipulate a surgical instrument, and a side effect of surgery may be reduced when the surgery is performed in a narrow surgical space in the human body.

According to the present disclosure as described above, the rotation radii of the pulley1111, which is a first jaw pulley, and the pulley1121, which is a second jaw pulley, increase, so that a yaw motion range in which a normal opening/closing actuation motion and a normal cutting motion can be performed may be increased.

(Actuation Hub)

FIGS.154A and154B are a perspective view and a cut-away perspective view illustrating an actuation hub of the surgical instrument for electrocautery ofFIG.147 ofFIG.140.FIG.155 is a view illustrating a state in which the guide tube, the blade wire, and the blade are mounted on the actuation hub illustrated in the cut-away perspective view ofFIG.154.FIG.156 is an exploded perspective view illustrating the end tool of the surgical instrument for electrocautery ofFIG.140.

Referring toFIGS.154 to156, the actuation hub1190 may be formed in the form of a box having a hollow therein. In addition, the actuation hub1190 is coupled to each of the first jaw1101 and the second jaw1102. In detail, the actuation hub1190 is axially coupled to the first jaw1101 by a first actuation rotation shaft1145a. In addition, the actuation hub1190 is axially coupled to the second jaw1102 by a second actuation rotation shaft1145b. In this case, the first actuation rotation shaft1145aand the second actuation rotation shaft1145bmay be disposed on the same line in a Z-axis direction.

In addition, a tube seating portion1190amay be formed inside the actuation hub1190, and one end portion of the guide tube1170 may be fixedly coupled to the tube seating portion1190a.

Meanwhile, a blade accommodation portion1190bmay be formed inside the actuation hub1190, and the blade1175 may be accommodated in the blade accommodation portion1190b.

In addition, a wire through-hole1190cmay be formed between the tube seating portion1190aand the blade accommodation portion1190binside the actuation hub1190.

That is, the tube seating portion1190a, the wire through-hole1190c, and the blade accommodation portion1190bare sequentially formed inside the actuation hub1190, and the blade wire307 may pass through the inside of the actuation hub1190 to be connected to the blade1175.

As described above, by providing the actuation hub1190 to which the guide tube1170 is coupled between the first jaw1101 and the second jaw1102, the guide tube1170 may not be curved, or the angle at which the guide tube1170 is curved may be reduced, even when the first jaw1101 or the second jaw1102 rotates around the first rotation shaft1141 or the actuation rotation shaft1145.

In detail, in a case in which the guide tube1170 is directly coupled to the first jaw1101 or the second jaw1102, when the first jaw1101 or the second jaw1102 rotates, one end portion of the guide tube1170 also rotates together with the first jaw1101 or the second jaw1102, causing the guide tube1170 to be curved.

On the other hand, in a case in which the guide tube1170 is coupled to the actuation hub1190, which is independent of the rotation of the jaw1103, as in the present embodiment, even when the first jaw1101 or the second jaw1102 rotates, the guide tube1170 may not be curved, or the angle at which the guide tube1170 is curved may be reduced even when the guide tube1170 is curved.

That is, by changing the direct connection between the guide tube1170 and the jaw1103 by the actuation hub1190 to an indirect connection, the degree to which the guide tube1170 is curved by the rotation of the jaw1103 may be reduced.

(First and Second Jaws and Actuation Motion)

Hereinafter, a coupling structure of the first jaw1101 and the second jaw1102 of the end tool1100 of the surgical instrument10 ofFIG.140 will be described in more detail.

Referring toFIGS.157 to162 and the like, the first jaw1101 includes a movable coupling hole1101c, a jaw pulley coupling hole1101d, and a shaft pass-through portion1101c.

The first jaw1101 is formed entirely in an elongated bar shape, and formed to be rotatable together with the pulley1111 by being coupled to the pulley1111 at one end portion thereof.

Meanwhile, the movable coupling hole1101c, the jaw pulley coupling hole1101d, and the shaft pass-through portion1101emay be formed in the first jaw1101 at a side coupled to the pulley1111, that is, at the proximal end side.

Here, the movable coupling hole1101cmay be formed to have a predetermined curvature, and may be formed in an approximately elliptical shape. A shaft coupling portion1111aof the pulley1111, which will be described later, may be fitted into the movable coupling hole1101c. Here, a short radius of the movable coupling hole1101cmay be formed to be substantially the same as or slightly greater than a radius of the shaft coupling portion1111a. Meanwhile, a long radius of the movable coupling hole1101cmay be formed to be greater than the radius of the shaft coupling portion1111a. Thus, in a state in which the shaft coupling portion1111aof the pulley1111 is fitted into the movable coupling hole1101cof the first jaw1101, the shaft coupling portion1111ais movable to a certain degree in the movable coupling hole1101c. This will be described in more detail below.

Meanwhile, the jaw pulley coupling hole1101dis formed in the form of a cylindrical hole, and a jaw coupling portion1111bof the pulley1111, which will be described later, may be fitted into the jaw pulley coupling hole1101d. Here, a radius of the jaw pulley coupling hole1101dmay be formed to be substantially the same as or slightly greater than a radius of the jaw coupling portion1111b. Thus, the jaw coupling portion1111bof the pulley1111 may be formed to be rotatably coupled to the jaw pulley coupling hole1101dof the first jaw1101. This will be described in more detail below.

Meanwhile, the shaft pass-through portion1101emay be formed in the first jaw1101 at the distal end side relative to the movable coupling hole1101cand the jaw pulley coupling hole1101d. The shaft pass-through portion1101emay be formed in the form of a hole, and the actuation rotation shaft1145, which is a jaw rotation shaft, may be inserted through the shaft pass-through portion1101c.

The second jaw1102 includes a movable coupling hole1102c, a jaw pulley coupling hole1102d, and a shaft pass-through portion1102c.

The second jaw1102 is formed entirely in an elongated bar shape, and formed to be rotatable together with the pulley1121 by being coupled to the pulley1121 at one end portion thereof.

Meanwhile, the movable coupling hole1102c, the jaw pulley coupling hole1102d, and the shaft pass-through portion1102emay be formed in the second jaw1102 at a side coupled to the pulley1111, that is, at the proximal end side.

Here, the movable coupling hole1102cmay be formed to have a predetermined curvature, and may be formed in an approximately elliptical shape. A shaft coupling portion1121aof the pulley1121, which will be described later, may be fitted into the movable coupling hole1102c. Here, a short radius of the movable coupling hole1102cmay be formed to be substantially the same as or slightly greater than a radius of the shaft coupling portion1121a. Meanwhile, a long radius of the movable coupling hole1102cmay be formed to be greater than the radius of the shaft coupling portion1121a. Thus, in a state in which the shaft coupling portion1121aof the pulley1121 is fitted into the movable coupling hole1102cof the second jaw1102, the shaft coupling portion1121ais movable to a certain degree in the movable coupling hole1102c. This will be described in more detail below.

Meanwhile, the jaw pulley coupling hole1102dis formed in the form of a cylindrical hole, and a jaw coupling portion1121bof the pulley1121, which will be described later, may be fitted into the jaw pulley coupling hole1102d. Here, a radius of the jaw pulley coupling hole1102dmay be formed to be substantially the same as or slightly greater than a radius of the jaw coupling portion1121b. Thus, the jaw coupling portion1121bof the pulley1121 may be formed to be rotatably coupled to the jaw pulley coupling hole1102dof the second jaw1102. This will be described in more detail below.

Meanwhile, the shaft pass-through portion1102emay be formed in the second jaw1102 at the distal end side relative to the movable coupling hole1102cand the jaw pulley coupling hole1102d. The shaft pass-through portion1102emay be formed in the form of a hole, and the actuation rotation shaft1145, which is a jaw rotation shaft, may be inserted through the shaft pass-through portion1102c.

The pulley1111, which is a first jaw pulley, may include the shaft coupling portion1111aand the jaw coupling portion1111b. The pulley1111 is formed entirely in the form of a rotatable disk, and the shaft coupling portion1111aand the jaw coupling portion1111bmay be formed to protrude to a certain degree from one surface of the pulley1111. As described above, the shaft coupling portion1111aof the pulley1111 may be fitted into the movable coupling hole1101cof the first jaw1101, and the jaw coupling portion1111bof the pulley1111 may be fitted into the jaw pulley coupling hole1101dof the first jaw1101. The pulley1111 may be formed to be rotatable with the first rotation shaft1141, which is an end tool jaw pulley rotation shaft, as the center of rotation.

Meanwhile, the pulley1121, which is a second jaw pulley, may include the shaft coupling portion1121aand the jaw coupling portion1121b. The pulley1121 is formed entirely in the form of a rotatable disk, and the shaft coupling portion1121aand the jaw coupling portion1121bmay be formed to protrude to a certain degree from one surface of the pulley1121. As described above, the shaft coupling portion1112aof the pulley1112 may be inserted into the movable coupling hole1102cof the second jaw1102, and the jaw coupling portion1112bof the pulley1112 may be inserted into the jaw pulley coupling hole1102dof the second jaw1102. The pulley1121 may be formed to be rotatable with the first rotation shaft1141, which is an end tool jaw pulley rotation shaft, as the center of rotation.

The coupling relationship between the components described above is as follows.

The first rotation shaft1141, which is an end tool jaw pulley rotation shaft, is sequentially inserted through the shaft coupling portion1111aof the pulley1111, the movable coupling hole1101cof the first jaw1101, the movable coupling hole1102cof the second jaw1102, and the shaft coupling portion1121aof the pulley1121.

The first actuation rotation shaft1145ais sequentially inserted through the shaft pass-through portion1101eof the first jaw1101 and the actuation hub1190 The second actuation rotation shaft1145bis sequentially inserted through the shaft pass-through portion1102eof the second jaw1102 and the actuation hub1190.

The shaft coupling portion1111aof the pulley1111 is fitted into the movable coupling hole1101cof the first jaw1101, and the jaw coupling portion1111bof the pulley1111 is fitted into the jaw pulley coupling hole1101dof the first jaw1101.

At this time, the jaw pulley coupling hole1101dof the first jaw1101 and the jaw coupling portion1111bof the pulley1111 are axially coupled to each other so as to be rotatable, and the movable coupling hole1101cof the first jaw1101 and the shaft coupling portion1111aof the pulley1111 are movably coupled to each other (here, “movably coupled” means that the shaft coupling portion1111aof the pulley1111 is coupled so as to be movable to a certain degree in the movable coupling hole1101cof the first jaw1101).

The shaft coupling portion1121aof the pulley1121 is fitted into the movable coupling hole1102cof the second jaw1102, and the jaw coupling portion1121bof the pulley1121 is fitted into the jaw pulley coupling hole1102dof the second jaw1102.

At this time, the jaw pulley coupling hole1102dof the second jaw1101 and the jaw coupling portion1121bof the pulley1121 are axially coupled to each other to be rotatable, and the movable coupling hole1102cof the second jaw1102 and the shaft coupling portion1121aof the pulley1121 are movably coupled to each other.

Here, the pulley1111 and the pulley1121 rotate around the first rotation shaft1141, which is an end tool jaw pulley rotation shaft. Meanwhile, the first jaw1101 and the second jaw1102 rotate around the actuation rotation shaft1145, which is a jaw rotation shaft. That is, the pulley1111 and the first jaw1101 have different shafts of rotation. Similarly, the pulley1121 and the second jaw1102 have different shafts of rotation.

That is, the rotation angle of the first jaw1101 is limited to a certain degree by the movable coupling hole1101c, but the first jaw1101 essentially rotates around the actuation rotation shaft1145, which is a jaw rotation shaft. Similarly, the rotation angle of the second jaw1102 is limited to a certain degree by the movable coupling hole1102c, but the second jaw1102 essentially rotates around the actuation rotation shaft1145, which is a jaw rotation shaft.

Amplification of a grip force due to the coupling relationship between the above-described components will be described.

In the surgical instrument110 according to an embodiment of the present disclosure, the coupling structure of the first jaw1101 and the second jaw1102 forms an X-shaped structure, and thus, when the first jaw1101 and the second jaw1102 rotate in a direction of approaching each other (i.e., when the first jaw1101 and the second jaw1102 are closed), the grip force is greater in a direction in which the first jaw1101 and the second jaw1102 are closed. This will be described below in more detail.

As described above, in motions of the first jaw1101 and the second jaw1102 being opened and closed, there are two shafts that serve as the centers of rotation for the first jaw1101 and the second jaw1102. That is, the first jaw1101 and the second jaw1102 perform the opening and closing motion around two shafts including the first rotation shaft1141 and the actuation rotation shaft1145. At this time, the centers of rotation of the first jaw1101 and the second jaw1102 become the actuation rotation shaft1145, and the centers of rotation of rotation of the pulley1111 and the pulley1121 become the first rotation shaft1141. At this time, the first rotation shaft1141 is a shaft whose position is relatively fixed, and the actuation rotation shaft1145 is a shaft whose position is relatively moved linearly. In other words, when the pulley1111 and the pulley1121 rotate in a state in which the position of the first rotation shaft1141 is fixed, the first jaw1101 and the second jaw1102 are opened/closed while the actuation rotation shaft1145, which is a rotation shaft of the first jaw1101 and the second jaw1102, is moved backward and forward. This will be described below in more detail.

InFIG.161, r1 is a distance from the jaw coupling portion1121bof the pulley1121 to the shaft coupling portion1121a, and a length thereof is constant. Thus, a distance from the first rotation shaft1141 inserted into the shaft coupling portion1121ato the jaw coupling portion1121bis also constant as r1.

Meanwhile, r2 ofFIG.161 is a distance from the jaw pulley coupling hole1102dof the second jaw1102 to the shaft pass-through portion1102e, and a length thereof is constant. Thus, a distance from the jaw coupling portion1121bof the pulley1121 inserted into the jaw pulley coupling hole1102dto the rotation shaft1145 inserted into the shaft pass-through portion1102eis also constant as r2.

That is, the lengths of r1 and r2 remain constant. Accordingly, when the pulley1111 and the pulley1121 rotate in the directions of an arrow B1 ofFIG.160 and an arrow B2 ofFIG.161, respectively, around the first rotation shaft1141 to perform a closing motion, the first jaw1101 and the second jaw1102 rotate around the actuation rotation shaft1145 as the angle between r1 and r2 changes while the lengths of r1 and r2 remain constant, and at this time, the actuation rotation shaft1145 itself is also linearly moved (i.e., is moved forward/backward) by as much as an arrow C1 ofFIG.160 and an arrow C2 ofFIG.161.

That is, assuming that the position of the first rotation shaft1141, which is an end tool jaw pulley rotation shaft, is fixed, when the first jaw1101 and the second jaw1102 are closed, a force is applied in a direction in which the actuation rotation shaft1145, which is a jaw rotation shaft, is moved forward (i.e., toward the distal end), and thus the grip force in the direction in which the first jaw1101 and the second jaw1102 are closed becomes larger.

In other words, since the lengths of r1 and r2 remain constant when the second jaw1102 rotates around the actuation rotation shaft1145, when the pulley1121 rotates around the first rotation shaft1141, the angle between r1 and r2 changes while the lengths of r1 and r2 remain constant. That is,02, which is the angle between r1 and r2 in a state in which the second jaw1102 is open as shown inFIG.161A, is greater than 01, which is the angle between r1 and r2 in a state in which the second jaw1102 is closed as shown inFIG.161B.

Thus, when the second jaw1102 rotates from the open state to the close state, the angle between r1 and r2 changes, and a force is applied in a direction in which the actuation rotation shaft1145 is moved forward.

In this case, since the first rotation shaft1141 is a shaft whose position is relatively fixed, the actuation rotation shaft1145 is moved forward in the direction of the arrow C1 ofFIG.160 and the direction of the arrow C2 ofFIG.161, and the grip force is further increased in a direction in which the second jaw1102 is closed.

In other words, when the pulley1111 and the pulley1121 rotate around the first rotation shaft1141, which is a shaft whose relative position is fixed, the angle θ between r1 and r2 changes while the distance between r1 and r2 remains constant. In addition, when the angle θ changes as described above, the first jaw1101 and the second jaw1102 push or pull the actuation rotation shaft1145, and thus the actuation rotation shaft1145 is moved forward or backward. In this case, when the first jaw1101 and the second jaw1102 are rotated in the direction of closing, the grip force is further increased as the actuation rotation shaft1145 is moved forward in the directions of the arrow C1 ofFIG.160 and the arrow C2 ofFIG.161. On the contrary, when the first jaw1101 and the second jaw1102 are rotated in the direction of opening, the actuation rotation shaft1145 is moved backward in directions opposite to the arrow C1 ofFIG.160 and the arrow C2 ofFIG.161.

With this configuration, the grip force becomes stronger when the first jaw1101 and the second jaw1102 are closed, thereby enabling a surgical operator to perform the actuation motion powerfully even with a small force.

(Components Associated with Cautery and Cutting)

Subsequently, referring toFIGS.140 to162 and the like, the end tool1100 of the fourth embodiment of the present disclosure may include the first jaw1101, the second jaw1102, a first electrode1151, a second electrode1152, the guide tube1170, and the blade1175 in order to perform cauterizing and cutting motions.

Here, components related to the driving of the blade, such as the guide tube1170 and the blade1175, may be collectively referred to as a blade assembly. In an embodiment of the present disclosure, by disposing the blade assembly including the guide tube1170 and the blade1175 between the pulley1111, which is a first jaw pulley, and the pulley1121, which a second jaw pulley, the end tool1100 is able to perform the cutting motion using the blade1175 in addition to the pitch and yaw motions. This will be described in more detail.

As described above, the first jaw1101 is connected to the first jaw pulley1111 and rotates around the first rotation shaft1141 together with the first jaw pulley1111 when the first jaw pulley1111 rotates around the first rotation shaft1141.

Meanwhile, the first electrode1151 may be formed on a surface of the first jaw1101 facing the second jaw1102. In addition, the second electrode1152 may be formed on a surface of the second jaw1102 facing the first jaw1101.

At this time, a slit1151amay be formed in the first electrode1151, and the blade1175 may move along the slit1151a. In addition, a slit1152amay be formed in the second electrode1152, and the blade1175 may move along the slit1152a.

Meanwhile, although not shown in the drawings, a spacer (not shown) may be formed between the first jaw1101 and the first electrode1151, and a spacer (not shown) may be formed between the second jaw1102 and the second electrode1152. The spacer (not shown) may include an insulating material such as ceramic. Alternatively, the first jaw1101 and the second jaw1102 may themselves be made of a nonconductor such that the first electrode1151 and the second electrode1152 may be maintained to be insulated from each other without a separate insulator until the first electrode1151 and the second electrode1152 are in contact with each other.

Meanwhile, although not shown in the drawings, one or more sensors (not shown) may be further formed on at least one of the first jaw1101 or the second jaw1102. The sensor (not shown) may be formed to measure at least some of current, voltage, resistance, impedance, and temperature during the cautery by locating tissue between the first jaw1101 and the second jaw1102 and passing a current through the first electrode1151 and the second electrode1152.

Alternatively, instead of providing a separate sensor, monitoring and controlling of at least some of current, voltage, resistance, impedance, and temperature may be directly performed by a generator (not illustrated) which supplies power to the electrodes.

An edge portion formed sharply and configured to cut tissue may be formed in one region of the blade1175. The tissue disposed between the first jaw1101 and the second jaw1102 may be cut as at least a part of the blade1175 moves between the distal end1104 and the proximal end1105 of the end tool1100.

Here, the guide tube1170 and the blade1175 disposed between the pulley1111 and the pulley1121 are provided in the end tool1100 of the electric cauterization surgical instrument10 according to an embodiment of the present disclosure. In addition, by providing the guide tube1170 and the blade1175, a multi-joint/multi-degree-of-freedom surgical instrument capable of pitch/yaw/actuation motions may also perform cauterizing and cutting motions. This will be described below in more detail.

So far, various types of surgical instruments for electrocautery have been developed. Among the various types of surgical instruments for electrocautery, a blood vessel resection device called “Advanced Energy Device” or “Vessel Sealer” has a sensing function added to the existing bipolar cautery method, so that power of different polarities may be supplied to two electrodes, and after denaturing a vessel with the heat generated therefrom for hemostasis, the stanched part may be cut with a blade. At this time, the impedance of the tissue (or blood vessel) while the current is flowing is measured to determine whether the cauterization is completed, and when the cauterization is completed, the current supply is automatically stopped, and the tissue is cut with the blade.

In the case of such a bipolar-type blood vessel resection device, it is essential to have a blade to cut the tissue after cauterization, and the end tool needs to be equipped with a mechanism for facilitating a linear motion of the blade, and thus joint movements such as pitch/yaw movements are not possible in most cases.

Meanwhile, there have been attempts to implement joint movements using flexible joints with multiple nodes connected in the bipolar-type blood vessel resection device, but in this case, a rotation angle is limited and it is difficult to achieve accurate motion control of the end tool.

On the other hand, in the case of a method that utilizes vibration of ultrasonic waves to perform hemostasis and cutting, it is not feasible to provide joints due to the physical properties of ultrasonic waves.

To address these problems, the end tool1100 of the electric cauterization surgical instrument10 according to an embodiment of the present disclosure includes the guide tube1170 disposed between the pulley1111 and the pulley1121, and the blade1175 that moves between a first position and a second position in response to the movement of the blade wire307 disposed inside the guide tube1170. In addition, by providing the guide tube1170 and the blade1175 as described above, pitch/yaw/actuation motions may also be performed using a pulley/wire in a bipolar-type surgical instrument for cauterizing and cutting tissue.

FIG.163 is a view illustrating a state in which the end tool of the surgical instrument for electrocautery ofFIG.140 is closed, andFIG.164 is a view illustrating a state in which the end tool of the surgical instrument for electrocautery ofFIG.140 is opened. In addition,FIG.165 is a view illustrating a state in which the blade wire307 and the blade1175 are located at a first position,FIG.166 is a view illustrating a state in which the blade wire307 and the blade1175 are located at a second position, andFIG.167 is a view illustrating a state in which the blade wire307 and the blade1175 are located at a third position.

Referring toFIGS.163 to167, it may be said that the tissue between the first jaw1101 and the second jaw1102 is cut as the cutting motion ofFIGS.165 to167 is performed in a state in which the first jaw1101 and the second jaw1102 are closed as shown inFIG.163.

Here, the first position illustrated inFIG.165 may be defined as a state in which the blade1175 is drawn in toward the proximal end1105 of the end tool1100 as much as possible. Alternatively, the first position may be defined as a state in which the blade1175 is located adjacent to the pulley1111/pulley1121.

Meanwhile, the third position illustrated inFIG.167 may be defined as a state in which the blade1175 is withdrawn toward the distal end1104 of the end tool1100 as much as possible. Alternatively, the third position may be defined as a state in which the blade1175 is spaced away from the pulley1111/pulley1121 as much as possible.

First, as shown inFIG.164, a tissue to be cut is located between the first jaw1101 and the second jaw1102 in a state in which the first jaw1101 and the second jaw1102 are opened, and then an actuation motion is performed to close the first jaw1101 and the second jaw1102 as shown inFIG.163.

Next, as shown inFIG.165, in a state in which the blade wire307 and the blade1175 are located at the first position, currents of different polarities are applied to the first electrode1151 and the second electrode1152 to cauterize the tissue between the first jaw1101 and the second jaw1102. At this time, a generator (not shown) configured to supply power to the electrodes may itself perform monitoring of at least some of current, voltage, resistance, impedance, and temperature, and may stop supplying power when the cauterization is completed.

In the state in which the cautery is completed as described above, when the blade wire307 moves sequentially in the directions of an arrow A1 ofFIG.155 and an arrow A2 ofFIG.167, the blade1175 coupled to the blade wire307 moves from the first position at the proximal end1105 of the end tool1100 toward the third position at the distal end1104 of the end tool1100, reaching the positions inFIGS.166 and167 in turn.

As such, the blade1175 cuts the tissue between the first jaw1101 and the second jaw1102 while moving in the X-axis direction.

However, it is to be understood that the linear motion of the blade1175 here does not mean a motion in a completely straight line, but rather means a motion of the blade1175 to the extent that the blade1175 is able to cut the tissue while achieving a linear motion when viewed as a whole, even though the motion is not in a completely straight line, for example, the middle part of the straight line is bent by a certain angle or there is a section having a gentle curvature in a certain section.

Meanwhile, in this state, when the blade wire307 is pulled in the opposite direction, the blade1175 coupled to the blade wire307 also returns to the first position.

According to the present disclosure, the multi-joint/multi-degree-of-freedom surgical instrument capable of pitch/yaw/actuation motions may also perform cauterizing and cutting motions.

(Manipulation Portion)

FIGS.216 and217 are perspective views illustrating the manipulation portion200 of the surgical instrument ofFIG.140.FIG.218 is a diagram schematically illustrating only the pulleys and the wires constituting the joint of the surgical instrument for electrocautery of FIG.140.

With reference toFIGS.140 to162 andFIGS.216 to218, the manipulation portion200 of the electric cauterization surgical instrument10 according to the fourth embodiment may include the first handle204 which a user may hold, the actuation manipulation portion203 configured to control the actuation motion of the end tool1100, the yaw manipulation portion202 configured to control the yaw motion of the end tool1100, and the pitch manipulation portion201 configured to control the pitch motion of the end tool1100.FIGS.216 and217 illustrate components only associated with the pitch/yaw/actuation motions of the electric cauterization surgical instrument10.

In addition, the manipulation portion200 of the electric cauterization surgical instrument10 may further include a blade manipulation portion260 performing cutting by controlling the movement of the blade171 of the end tool1100, and a cautery manipulation portion270 performing cautery by supplying electrical energy to the first electrode1151 and the second electrode1152 of the end tool1100.

The manipulation portion200 may include a pulley210, a pulley211, a pulley212, a pulley213, a pulley214, a pulley215, a pulley216, a pulley217, and a pulley218, which are associated with the rotational motion of the first jaw1101. In addition, the manipulation portion200 may include a pulley220, a pulley221, a pulley222, a pulley223, a pulley224, a pulley225, a pulley226, a pulley227, and a pulley228, which are associated with the rotational motion of the second jaw1102. In one embodiment, the manipulation portion200 may include a pulley231, a pulley232, a pulley233, and a pulley234, which are associated with the pitch motion. The manipulation portion200 may include a pulley235 which is an intermediate pulley arranged in some positions of the bent portion402 of the connection portion400.

Here, the drawings illustrate that the pulleys facing each other are arranged in parallel with each other; however, the technical concepts of the present disclosure are not limited thereto, and each pulley may be formed in various positions and sizes suitable for the configuration of the manipulation portion200.

In addition, the manipulation portion200 of the fourth embodiment may include a rotation shaft241, a rotation shaft242, a rotation shaft243, a rotation shaft244, a rotation shaft245, and a rotation shaft246. Here, the rotation shaft241 may function as a manipulation portion first jaw actuation rotation shaft, and the rotation shaft242 may function as a manipulation portion second jaw actuation rotation shaft. In addition, the rotation shaft243 may function as a manipulation portion yaw main rotation shaft, and the rotation shaft244 may function as a manipulation portion yaw subsidiary rotation shaft. The rotation shaft245 may function as a manipulation portion pitch subsidiary rotation shaft, and the rotation shaft246 may function as a manipulation portion pitch main rotation shaft.

The rotation shaft241, the rotation shaft242, the rotation shaft243, the rotation shaft244, the rotation shaft245, and the rotation shaft246 may be sequentially arranged in a direction towards a proximal end206 from a distal end205.

One or more pulleys may be fit into each of the rotation shafts241,242,243,244,245, and246 which will be described in detail below.

The pulley210 may function as a manipulation portion first jaw actuation pulley, the pulley220 may function as a manipulation portion second jaw actuation pulley, and these components may be collectively referred to as a manipulation portion actuation pulley.

The pulley211 and the pulley212 may function as a manipulation portion first jaw yaw main pulley, the pulley221 and the pulley222 may function as a manipulation portion second jaw yaw main pulley, and these two components may collectively be referred to as a manipulation portion yaw main pulley.

The pulley213 and the pulley214 may function as a manipulation portion first jaw yaw subsidiary pulley, the pulley223 and the pulley224 may function as a manipulation portion second jaw yaw subsidiary pulley, and these two components may collectively be referred to as a manipulation portion yaw subsidiary pulley.

The pulley215 and the pulley216 may function as a manipulation portion first jaw pitch subsidiary pulley, the pulley225 and the pulley226 may function as a manipulation portion second jaw pitch subsidiary pulley, and these two components may collectively be referred to as a manipulation portion pitch subsidiary pulley.

The pulley217 and the pulley218 may function as a manipulation portion first jaw pitch main pulley, the pulley227 and the pulley228 may function as a manipulation portion second jaw pitch main pulley, and these two components may collectively be referred to as a manipulation portion pitch main pulley.

The pulley231 and the pulley232 may function as a manipulation portion pitch wire main pulley, and the pulley233 and the pulley234 may function as a manipulation portion pitch wire subsidiary pulley.

The components may be classified from the viewpoint of the manipulation portion in connection with each motion (i.e., pitch/yaw/actuation) as follows.

The pitch manipulation portion201 controlling the pitch motion of the end tool1100 may include a pulley215, a pulley216, a pulley217, a pulley218, a pulley225, a pulley226, and a pulley227, a pulley228, a pulley231, a pulley232, and a pulley234. In addition, the pitch manipulation portion201 may include the rotation shaft245 and the rotation shaft246. In one embodiment, the pitch manipulation portion201 may further include a pitch frame208.

The yaw manipulation portion202 controlling the yaw motion of the end tool1100 may include a pulley211, a pulley212, a pulley213, a pulley214, a pulley221, a pulley222, a pulley223, and a pulley224. In addition, the yaw manipulation portion202 may include the rotation shaft243 and the rotation shaft244. In one embodiment, the yaw manipulation portion202 may further include a yaw frame207.

The actuation manipulation portion203 controlling the actuation motion of the end tool1100 may include the pulley210, the pulley220, the rotation shaft241, and the rotation shaft242. In one embodiment, the actuation manipulation portion203 may further include a first actuation manipulation portion251 and a second actuation manipulation portion256.

Hereinafter, each component of the manipulation portion200 will be described in more detail.

The first handle204 may be held by a user, and more particularly, a user may hold the first handle204 by wrapping it with his or her hand. The actuation manipulation portion203 and the yaw manipulation portion202 may be formed on the first handle204, and the pitch manipulation portion201 may be formed on one side of the yaw manipulation portion202. In addition, another end of the pitch manipulation portion201 may be connected to the bent portion402 of the connection portion400.

The actuation manipulation portion203 may include the first actuation manipulation portion251 and the second actuation manipulation portion256. The first actuation manipulation portion251 may include the rotation shaft241, the pulley210, a first actuation extension portion252, and a first actuation gear253. The second actuation manipulation portion256 may include the rotation shaft242, the pulley220, a second actuation extension portion257, and a second actuation gear258. Here, ends of the first actuation extension portion252 and the second actuation extension portion257 may be formed in the shape of a hand ring, and may operate as a second handle.

The rotation shaft241 and the rotation shaft242, which are the actuation rotation shaft, may be formed to have a certain angle with the XY plane on which the connection portion400 is formed. For example, the rotation shaft241 and the rotation shaft242 may be formed in a direction parallel with the Z-axis, and when the pitch manipulation portion201 or the yaw manipulation portion203 rotates, a coordinate system of the actuation manipulation portion203 may be changed relatively. However, the technical ides of the present disclosure are not limited thereto, and by an ergonomic design, the rotation shaft241 and the rotation shaft242 may be formed in various directions suitable for a hand structure of a user holding the actuation manipulation portion203.

The pulley210, the first actuation extension portion252, and the first actuation gear253 may be fixedly coupled to each other and rotatable together around the rotation shaft241. Here, the pulley210 may include one pulley or two pulleys fixedly coupled to each other.

Likewise, the pulley220, the second actuation extension portion257, and the second actuation gear258 may be fixedly coupled to each other and rotatable together around the rotation shaft242. Here, the pulley220 may include one pulley or two pulleys fixedly coupled to each other.

The first actuation gear253 and the second actuation gear258 may be formed to engage with each other, and when either one of them rotates in one direction, the other one may rotate concurrently in the opposite direction.

The yaw manipulation portion202 may include the rotation shaft243, the pulley211 and the pulley212, which are the manipulation portion first jaw yaw main pulley, the pulley211 and the pulley212, which are the manipulation portion second jaw yaw main pulley, and the yaw frame207. In addition, the yaw manipulation portion202 may further include the pulley213 and the pulley214, which are the manipulation portion first jaw yaw subsidiary pulley and arranged on one side of the pulley211 and the pulley212, and the pulley223 and the pulley224, which are the manipulation portion second jaw yaw subsidiary pulley and arranged on one side of the pulley221 and the pulley222. Here, the pulley213, the pulley214, the pulley223, and the pulley224 may be coupled to the pitch frame208 to be described later.

The drawings illustrate that the yaw manipulation portion202 includes the pulley211, the pulley212, the pulley221, and the pulley222, and as the pulley211 faces the pulley212 and the pulley221 faces the pulley222, two pulleys may be rotatable independently of each other; however the technical concepts of the present disclosure are not limited thereto. That is, one or more pulleys having the same diameter or different diameters may be provided according to the configuration of the yaw manipulation portion202.

More specifically, on the first handle204, the rotation shaft243, which is the manipulation portion yaw main rotation shaft, may be formed on one side of the actuation manipulation portion203. In this case, the first handle204 may be formed to be rotatable around the rotation shaft243.

Here, the rotation shaft243 may be formed to have a certain angle with the XY plane on which the connection portion400 is formed. For example, the rotation shaft243 may be formed in a direction parallel with the Z-axis, and when the pitch manipulation portion201 rotates, the coordinate system of the rotation shaft243 may be changed relatively as described above. However, the technical ides of the present disclosure are not limited thereto, and by an ergonomic design, the rotation shaft243 may be formed in various directions suitable for a hand structure of a user holding the manipulation portion200.

The pulley211, the pulley212, the pulley221, and the pulley222 may be coupled to the rotation shaft243 to be rotatable around the rotation shaft243. In addition, the wire301 or the wire305, which is the first jaw wire, may be wound around the pulley211 and the pulley212, and the wire302 or the wire306, which is the second jaw wire, may be wound around the pulley221 and the pulley222. At this time, as the pulley211 faces the pulley212, and the pulley221 faces the pulley222, there may be two pulleys which are rotatable independently. Accordingly, as the wire wound inward and the wire wound outward may be respectively wound around separate pulleys, the pulleys may operate without interfering with each other.

The yaw frame207 may rigidly connect the first handle204, the rotation shaft241, the rotation shaft242, and the rotation shaft243, and accordingly, the first handle204, the yaw manipulation portion202, and the actuation manipulation portion203 may yaw-rotate around the rotation shaft243 in an integrated manner.

The pitch manipulation portion201 may include the rotation shaft246, the pulley217 and the pulley218, which are the manipulation portion first jaw pitch main pulley, the pulley227 and the pulley228, which are the manipulation portion second jaw pitch main pulley, and the pitch frame208. In addition, the pitch manipulation portion201 may further include the rotation shaft245, the pulley215 and the pulley216, which are the manipulation portion first jaw pitch subsidiary pulley and arranged on one side of the pulley217 and the pulley218, and the pulley225 and the pulley226, which are the manipulation portion second jaw pitch subsidiary pulley and arranged on one side of the pulley227 and pulley228. The pitch manipulation portion201 may be connected to the bent portion402 of the connection portion400 through the rotation shaft246.

More specifically, the pitch frame208 may be a base frame of the pitch manipulation portion201, and one end of the pitch frame208 may be rotatably coupled to the rotation shaft243. That is, the yaw frame207 may be formed to be rotatable around the rotation shaft243 with respect to the pitch frame208.

As described above, the yaw frame207 may connect the first handle204, the rotation shaft243, the rotation shaft241, and the rotation shaft242, and as the yaw frame207 is axially coupled to the pitch frame208, when the pitch frame208 pitch-rotates around the rotation shaft246, the yaw frame207, the first handle204, the rotation shaft241, the rotation shaft242, and the rotation shaft243, which are connected to the pitch frame208, may also pitch rotate. That is, when the pitch manipulation portion201 rotates around the rotation shaft246, the actuation manipulation portion203 and the yaw manipulation portion202 may be rotated together with the pitch manipulation portion201. In other words, when the user pitch-rotates the first handle204 around the rotation shaft246, the actuation manipulation portion203, the yaw manipulation portion202, and the pitch manipulation portion201 may also move together with the first handle204.

The pulley217, the pulley218, the pulley227, and the pulley228 may be coupled to the rotation shaft246 so that they are rotatable around the rotation shaft246 of the pitch frame208.

Here, the pulley217 and the pulley218 may face each other and rotate independently. Accordingly, as the wire wound inward and the wire wound outward may be respectively wound around separate pulleys, the pulleys may operate without interfering with each other. Likewise, the pulley227 and the pulley228 may face each other and rotate independently. Accordingly, as the wire wound inward and the wire wound outward may be respectively wound around separate pulleys, the pulleys may operate without interfering with each other.

Next, the motions of the wire303 and the wire304 which are the pitch wire are described below.

In the end tool1100, the pulley1131, which is the end tool pitch pulley, may be fixedly coupled to the end tool hub1180, and in the manipulation portion200, the pulley231 and the pulley232, which are the manipulation portion pitch pulley, may be fixedly coupled to the pitch frame208. These pulleys may be connected to each other by the wire303 and the wire304, which are the pitch wire, to facilitate the pitch motion of the end tool1100 according to the pitch manipulation of the manipulation portion200. Here, the wire303 may be fixedly coupled to the pitch frame208 via the pulley231 and the pulley233, and the wire304 may be fixedly coupled to the pitch frame208 via the pulley232 and the pulley234. That is, the pitch frame208, the pulley231, and the pulley232 may rotate together around the rotation shaft246 by the pitch rotation of the manipulation portion200. As a result, the wire303 and the wire304 may also move, and separately from the pitch motion of the end tool1100 by the wire301, the wire302, the wire305, and the wire306, which are the jaw wire, additional pitch rotation power may be transmitted.

The connection relation among the first handle204, the pitch manipulation portion201, the yaw manipulation portion202, and the actuation manipulation portion203 is described below. On the first handle204, the rotation shaft241, the rotation shaft242, the rotation shaft243, the rotation shaft244, the rotation shaft245, and the rotation shaft246 may be formed. At this time, as the rotation shaft241 and the rotation shaft242 are directly formed on the first handle204, the first handle204 and the actuation manipulation portion203 may be directly connected to each other. As the rotation shaft243 is directly formed on the first handle204, the first handle204 and the yaw manipulation portion202 may be directly connected to each other. As the pitch manipulation portion201 is arranged on one side of the yaw manipulation portion202 and connected to the yaw manipulation portion202, the pitch manipulation portion201 may not be directly connected to the first handle204 and the pitch manipulation portion201 and the first handle204 may be indirectly connected to each other through the yaw manipulation portion202.

With reference to the drawings, in the electric cauterization surgical instrument10 according to the first embodiment, the pitch manipulation portion201 and the end tool1100 may be formed on the same or parallel axis (i.e., the X-axis). That is, the rotation shaft246 of the pitch manipulation portion201 may be formed at one end of the bent portion402 of the connection portion400, and the end tool1100 may be formed at the other end of the connection portion400.

In addition, one or more intermediate pulleys235 changing or guiding a path of the wires may be arranged in some positions of the connection portion400, in particular, in positions on the bent portion402. At least a part of the wires may be wound around the intermediate pulleys235 to guide the path of the wires so that the wires are arranged along the bent shape of the bent portion402.

Here, the drawings illustrate that the connection portion400 includes the bent portion402 and thus is formed in a curved manner with a certain curvature; however, the technical concepts of the present disclosure are not limited thereto, and the connection portion400 may be formed straightly, if necessary, or curved in one or more points. Even in such cases, the pitch manipulation portion201 and the end tool1100 may be formed on the substantially same or parallel axis. In addition, althoughFIG.3 illustrates that the pitch manipulation portion201 and the end tool1100 are respectively formed on an axis parallel with the X-axis, the technical concepts of the present disclosure are not limited thereto, and the pitch manipulation portion201 and the end tool1100 may be formed on different axes.

(Actuation Motion, Yaw Motion, Pitch Motion)

Actuation motion, yaw motion, and pitch motion in this embodiment will be described as follows.

First, the actuation motion is as follows.

When a user puts the index finger in a hand ring formed at the first actuation extension252, puts the thumb in a hand ring formed at the second actuation extension257, and rotates the first actuation extension252 and the second actuation extension257 using any one of or both the fingers, the pulley210 and the first actuation gear253 fixedly coupled to the first actuation extension252 rotate around the rotation shaft241, and the pulley220 and the second actuation gear258 fixedly coupled to the second actuation extension257 rotate around the rotation shaft242. At this time, the pulley210 and the pulley220 rotate in opposite directions, and thus the wire301 and the wire305 each having one end fixedly coupled to and wound around the pulley210 and the wire302 and the wire306 each having one end fixedly coupled to and wound around the pulley220 move in opposite directions as well. This rotational force is transmitted to an end tool1100 through a power transmission portion300, two jaws1103 of the end tool1100 perform the actuation motion.

Here, the actuation motion refers to an action of opening or closing the jaws1102 while the two jaws1102 rotate in opposite directions to each other, as described above. In other words, when the actuation extensions252 and257 of the actuation manipulation portion203 are rotated in directions toward each other, the first jaw1101 rotates counterclockwise and the second jaw1102 rotates clockwise, and thus the end tool1100 is closed. Conversely, when the actuation extensions252 and257 of the actuation manipulation portion203 are rotated in directions away from each other, the first jaw1101 rotates clockwise and the second jaw1102 rotates counterclockwise, and thus the end tool1100 is opened.

In this embodiment, for the above-described actuation manipulation, the first actuation extension252 and the second actuation extension257 were provided to constitute a second handle, and two fingers were gripped to enable manipulation. However, unlike the above, the actuation manipulation portion203 for actuation manipulation to open and close the two jaws of the end tool1100 with each other may be configured differently so that, for example, two actuation pulleys (the pulley210 and the pulley220) operate opposite to each other by one actuation rotating portion.

Next, the yaw motion is as follows.

When the user rotates a first handle204 around a rotation shaft243 while holding the first handle204, the actuation manipulation portion203 and the yaw manipulation portion202 yaw-rotates around the rotation shaft243. In other words, when the pulley210 of the first actuation manipulation portion251 to which the wire301 and the wire305 are fixedly coupled rotates about the rotation shaft243, the wire301 and the wire305 respectively wound around the pulley211 and the pulley212 move. Likewise, when the pulley220 of the second actuation manipulation portion256 to which the wire302 and the wire306 are fixedly coupled rotates about the rotation shaft243, the wire302 and the wire306 respectively wound around the pulley221 and the pulley222 move. At this time, the wire301 and the wire305 connected to the first jaw1101 and the wire302 and the wire306 connected to the second jaw1102 are respectively wound around the pulley211 and the pulley212 and the pulley221 and the pulley222, such that the first jaw1101 and the second jaw1102 rotate in the same direction during a yaw rotation. And, this rotational force is transmitted to the end tool1100 through the power transmission portion300, the two jaws1103 of the end tool1100 performs the yaw motion that rotates in the same direction.

At this time, since the yaw frame207 connects the first handle204, the rotation shaft241, the rotation shaft242, and the rotation shaft243, the first handle204, the yaw manipulation portion202, and the actuation manipulation portion203 rotate together around the rotation shaft243.

Next, the pitch motion is as follows.

When the user rotates a first handle204 around a rotation shaft246 while holding the first handle204, the actuation manipulation portion203, the yaw manipulation portion202, and the pitch manipulation portion201 make pitch rotation around the rotation shaft243. In other words, when the pulley210 of the first actuation manipulation portion251 to which the wire301 and the wire305 are fixedly coupled rotates about the rotation shaft246, the wire301 and the wire305 respectively wound around the pulley217 and the pulley218 move. Likewise, when the pulley220 of the second actuation manipulation portion256 to which the wire302 and the wire306 are fixedly coupled rotates about the rotation shaft246, the wire302 and the wire306 respectively wound around the pulley227 and the pulley228 move. Here, as described above with reference toFIG.5, the wire301, the wire305, the wire302, and the wire306, which are jaw wires, are wound around the pulley217, the pulley218, the pulley227, and the pulley228, which are manipulation portion pitch main pulleys, such that the wire301 and wire305, which are first jaw wires, move in the same direction and the wire302 and the wire306, which are second jaw wires, move in the same direction to enable pitch rotation of the first jaw1101 and the second jaw1102. And, this rotational force is transmitted to an end tool1100 through a power transmission portion300, two jaws1103 of the end tool1100 perform the pitch motion.

At this time, the pitch frame208 is connected to the yaw frame207 and the yaw frame207 connects the first handle204, the rotation shaft241, the rotation shaft242, and the rotation shaft243. Therefore, when the pitch frame208 rotates around the rotation shaft246, the yaw frame207 connected to the pitch frame208, the first handle204, the rotation shaft241, the rotation shaft242, and the rotation shaft243 rotate together. That is, when a pitch manipulation portion201 rotates around the rotation shaft246, the actuation manipulation portion203 and the yaw manipulation portion202 are rotated together with the pitch manipulation portion201.

In summary, in an electric cauterization surgical instrument10 according to an embodiment of the present disclosure, it is characterized that pulleys are formed at each joint point (actuation joint, yaw joint, pitch joint), wire (first jaw wire or second jaw wire) is wound on the pulley, and rotational manipulation of the manipulation portion (actuation rotation, yaw rotation, pitch rotation) causes movement of each wire, as a result, a desired motion of the end tool1100 is induced. Furthermore, auxiliary pulleys may be formed on one side of each pulley, and the wire may not be wound several times on one pulley by these auxiliary pulleys.

FIG.218 is a schematic view of only the configuration of pulleys and wires constituting joints of the electric cauterization surgical instrument10 according to an embodiment of the present disclosure shown inFIG.140. InFIG.218, intermediate pulleys that are for changing paths of wires and are not associated with joint motions are omitted.

Referring toFIG.218, the manipulation portion200 may include the pulley210, the pulley211, the pulley212, the pulley213, the pulley214, the pulley215, the pulley216, the pulley217, and the pulley218 that are associated with the rotational motion of the first jaw1101.

Also, the manipulation portion200 may include the pulley220, the pulley221, the pulley222, the pulley223, the pulley224, the pulley225, the pulley226, the pulley227, and the pulley228 associated with the rotational motion of the second jaw1102. (The arrangement and the configuration of pulleys in the manipulation portion200 are the same as the arrangement and the configuration of the pulleys in the end tool1100 in principle, and thus some of the reference numerals thereof will be omitted in the drawings.)

The pulley211 and the pulley212 and the pulley221 and the pulley222 may be formed to be rotatable independently of each other around the same axis, that is, the rotation shaft243. At this time, the pulley211 and the pulley212 may be formed to face the pulley221 and the pulley222, respectively, thereby forming two independently rotatable pulleys.

The pulley213 and the pulley214 and the pulley223 and the pulley224 may be formed to be rotatable independently of each other around the same axis, that is, the rotation shaft244. At this time, the pulley213 and the pulley214 may be formed to face each other as two independently rotatable pulleys, and, in this case, the two pulleys may be formed to have different diameters. Likewise, the pulley223 and the pulley224 may be formed to face each other as two independently rotatable pulleys, and, in this case, the two pulleys may be formed to have different diameters.

The pulley215 and the pulley216 and the pulley225 and the pulley226 may be formed to be rotatable independently of each other around the same axis, that is, the rotation shaft245. In this case, the pulley215 and the pulley216 may be formed to have different diameters. Also, the pulley225 and the pulley226 may be formed to have different diameters.

The pulley217 and the pulley218 and the pulley227 and the pulley228 may be formed to be rotatable independently of each other around the same axis, that is, the rotation shaft246.

The wire301 sequentially passes through the pulley217, the pulley215, the pulley213, and the pulley211 of the manipulation portion200, is wound around the pulley210, and then is coupled to the pulley210 by a fastening member324. Meanwhile, the wire305 sequentially passes through the pulley218, the pulley216, the pulley214, and the pulley212 of the manipulation portion200 and is coupled to the pulley210 by the fastening member324. Therefore, as the pulley210 rotates, the wire301 and the wire305 are wound around or unwound from the pulley210, and thus the first jaw1101 rotates.

The wire306 sequentially passes through the pulley227, the pulley225, the pulley223, and the pulley221 of the manipulation portion200, is wound around the pulley220, and then is coupled to the pulley220 by a fastening member327. Meanwhile, the wire302 sequentially passes through the pulley228, the pulley226, the pulley224, and the pulley222 of the manipulation portion200 and is coupled to the pulley220 by the fastening member327. Therefore, as the pulley220 rotates, the wire302 and the wire306 are wound around or unwound from the pulley220, and thus the second jaw1102 rotates.

(Conceptual Diagram of Pulleys and Wires)

FIGS.220 and221 are diagrams illustrating a configuration of pulleys and wires, which are associated with an actuation motion and a yaw motion of the electric cauterization surgical instrument10 according to an embodiment of the present disclosure illustrated inFIG.140, in detail for each of the first jaw and the second jaw.FIG.220 is a diagram illustrating only pulleys and wires related to the second jaw, andFIG.221 is a diagram illustrating only pulleys and wires related to the first jaw. In addition,FIG.219 is a perspective view illustrating a yaw motion of the surgical instrument shown inFIG.140. Here, inFIG.219, components associated with a cutting motion are omitted.

First, a wire operation in an actuation motion will be described.

Referring toFIG.221, when the first actuation extension252 rotates around the rotation shaft241 in the direction of an arrow OPA1, the pulley210 connected to the first actuation extension252 is rotated, and the wire301 and the wire305 wound around the pulley210 are moved in directions W1aand W1b, respectively, and as a result, the first jaw1101 of the end tool1100 is rotated in the direction of an arrow EPA1.

Referring toFIG.220, when the second actuation extension257 rotates around the rotation shaft242 in the direction of an arrow OPA2, the pulley220 connected to the second actuation extension257 is rotated, and thus both strands of the wires302 and306 wound around the pulley220 are moved in directions W2aand W2b, respectively, and as a result, the second jaw1102 of the end tool1100 is rotated in the direction of an arrow EPA2. Accordingly, when a user manipulates the first actuation extension252 and the second actuation extension257 in directions close to each other, a motion of the first jaw1101 and the second jaw1102 of the end tool being close to each other is performed.

Next, a wire operation in a yaw motion will be described.

First, since the rotation shaft243 is connected to the rotation shafts241 and242 by the yaw frame (see207 ofFIG.216), the rotation shaft243 and the rotation shafts241 and242 are integrally rotated together.

Referring toFIG.221, when the first handle204 rotates around the rotation shaft243 in the direction of an arrow OPY1, the pulley210 and the pulleys211 and212 and the wires301 and305 wound therearound are rotated as a whole around the rotation shaft243, and as a result, the wires301 and305 wound around the pulleys211 and212 are moved in the directions W1aand W1b, respectively, which in turn causes the first jaw1101 of the end tool1100 to rotate in the direction of an arrow EPY1.

Referring toFIG.220, when the first handle204 rotates around the rotation shaft243 in the direction of an arrow OPY2, the pulley220 and the pulleys221 and222 and the wires302 and306 wound therearound are rotated as a whole around the rotation shaft243, and as a result, the wires302 and306 wound around the pulleys221 and222 are respectively moved in a direction opposite to the direction W1aand a direction opposite to the direction W1b, which in turn causes the first jaw1101 of the end tool1100 to rotate in the direction of an arrow EPY2.

FIGS.223 and224 are diagrams illustrating a configuration of pulleys and wires, which are associated with a pitch motion of the electric cauterization surgical instrument10 according to an embodiment of the present disclosure illustrated inFIG.140, in detail for each of the first jaw and the second jaw.FIG.223 is a diagram illustrating only pulleys and wires related to the second jaw, andFIG.224 is a diagram illustrating only pulleys and wires related to the first jaw. As shown inFIG.140 and elsewhere herein, there are two pulleys related to the pitch motion, and both strands of each wire are wound in the same path, which is illustrated with one line inFIG.223. In addition,FIG.222 is a perspective view illustrating a pitch motion of the surgical instrument ofFIG.140. Here, inFIG.222, components associated with a cutting motion are omitted.

Referring toFIG.223, when the first handle204 rotates around the rotation shaft246 in the direction of an arrow OPP1, the pulley210, the pulley215, the pulley217, and the like, and the wire301 and the like wound therearound are rotated as a whole around the rotation shaft246. At this time, since the wires301 and305, which are first jaw wires, are wound around upper portions of the pulley217 and the pulley218, the wires301 and305 are moved in the direction of an arrow W1. As a result, the first jaw1101 of the end tool1100 rotates in the direction of an arrow EPP1.

Referring toFIG.224, when the first handle204 rotates around the rotation shaft246 in the direction of an arrow OPP2, the pulley220, the pulley225, the pulley227, and the like, and the wire302 and the like wound therearound are rotated as a whole around the rotation shaft246. At this time, since the wires302 and306, which are second jaw wires, are wound around lower portions of the pulley227 and the pulley228, the wires302 and306 are moved in the direction of an arrow W2. As a result, the second jaw1102 of the end tool1100 rotates in the direction of an arrow EPP2.

Thus, the actuation, yaw, and pitch manipulations are manipulatable independent of each other.

As described with reference toFIG.140, the actuation manipulation portion203, the yaw manipulation portion202, and the pitch manipulation portion201 are configured such that the respective rotation shafts are located at the rear thereof to be identical to the joint configuration of the end tool, so that a user may intuitively perform matching manipulations.

In particular, in the electric cauterization surgical instrument10 according to an embodiment of the present disclosure, the pulleys are formed on respective joint points (an actuation joint, a yaw joint, and a pitch joint), the wires (the first jaw wire or the second jaw wire) are formed to be wound around the pulleys, the rotational manipulations (actuation rotation, yaw rotation, and pitch rotation) of the manipulation portion cause the movement of each wire, which in turn induces the desired motion of the end tool1100. Furthermore, the auxiliary pulleys may be formed on one side of the respective pulleys, and these auxiliary pulleys may prevent the wire from being wound around one pulley multiple times, so that the wires wound around the pulley do not come into contact with each other, and paths of the wire being wound around the pulley and the wire being released from the pulley are safely formed, so that safety and efficiency in the transmission of driving force of a wire may be improved.

Meanwhile, as described above, the yaw manipulation portion202 and the actuation manipulation portion203 are directly formed on the first handle204. Thus, when the first handle204 rotates around the rotation shaft246, the yaw manipulation portion202 and the actuation manipulation portion203 are also rotated together with the first handle204. Accordingly, the coordinate systems of the yaw manipulation portion202 and the actuation manipulation portion203 are not fixed, but are continuously changed relative to the rotation of the first handle204. That is, inFIG.140 or the like, the yaw manipulation portion202 and the actuation manipulation portion203 are illustrated as being parallel to the Z-axis. However, when the first handle204 is rotated, the yaw manipulation portion202 and the actuation manipulation portion203 are not parallel to the Z-axis any longer. That is, the coordinate systems of the yaw manipulation portion202 and the actuation manipulation portion203 are changed according to the rotation of the first handle204. However, in the present specification, for convenience of description, unless described otherwise, the coordinate systems of the yaw manipulation portion202 and the actuation manipulation portion203 are described on the basis of a state in which the first handle204 is located perpendicular to the connection portion400 as illustrated inFIG.2.

(Pitch, Yaw, and Cutting Motions of End Tool)

FIGS.168 and169 are views illustrating a process of performing an opening and closing motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.140 is yaw-rotated by +90°. In addition,FIGS.170 and171 are views illustrating a process of performing an opening and closing motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.140 is yaw-rotated by −90°.

As shown inFIGS.168 to171, the end tool of the surgical instrument for electrocautery according to the fourth embodiment of the present disclosure is formed to be able to normally perform an opening and closing motion, that is, an actuation motion even in a state in which the jaws are yaw-rotated by +90° or −90°.

FIGS.172 and173 are views illustrating a process of performing a cutting motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.140 is yaw-rotated by +90°.

As shown inFIGS.172 and173, the end tool of the surgical instrument for electrocautery according to the fourth embodiment of the present disclosure is formed to be able to normally perform a cutting motion even in a state in which the jaws are yaw-rotated by +90°.

FIGS.174 and175 are views illustrating a process of performing an opening and closing motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.140 is pitch-rotated by +90°.FIGS.176 and177 are views illustrating a process of performing an opening and closing motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.140 is pitch-rotated by −90°. In addition,FIG.178 is a cut-away perspective view of the end tool of the surgical instrument for electrocautery ofFIG.176. In addition,FIGS.179 and180 are views illustrating a process of performing a cutting motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.140 is pitch-rotated by −90°.

As shown inFIGS.174 to180, the end tool of the surgical instrument for electrocautery according to the fourth embodiment of the present disclosure is formed to be able to normally perform a cutting motion even in a state in which the jaws are pitch-rotated by −90°.

Meanwhile,FIG.181 is a view illustrating a state in which the jaws are pitch-rotated by −90° and simultaneously yaw-rotated by +90°, andFIGS.182,183, and184 are perspective views illustrating a cutting motion of the end tool of the surgical instrument for electrocautery ofFIG.140 and illustrate a state of performing a cutting motion while the jaws are pitch-rotated by −90° and simultaneously yaw-rotated by +90°.

As shown inFIGS.181 to184, the end tool of the surgical instrument for electrocautery according to the fourth embodiment of the present disclosure is formed to be able to normally perform a cutting motion even in a state in which the jaws are pitch-rotated by −90° and simultaneously yaw-rotated by +90°.

First Modified Example of Fourth Embodiment

Hereinafter, an end tool1200 of a surgical instrument according to a first modified example of the fourth embodiment of the present disclosure will be described. Here, the end tool1200 of the surgical instrument according to the first modified example of the fourth embodiment of the present disclosure is different from the end tool (see1100 inFIG.140 or the like) of the surgical instrument according to the fourth embodiment of the present disclosure described above in that the configuration of an actuation hub1290 is different. The configuration changed from the fourth embodiment as described above will be described in detail later.

FIGS.185 and186 are perspective views illustrating the end tool of the surgical instrument for electrocautery according to the first modified example of the fourth embodiment of the present disclosure.FIGS.187 and188 are plan views illustrating the end tool of the surgical instrument for electrocautery according to the first modified example of the fourth embodiment of the present disclosure.FIGS.189 and190 are views illustrating an actuation hub of the surgical instrument for electrocautery according to the first modified example of the fourth embodiment of the present disclosure.

Referring toFIGS.185 to190, the end tool1200 of the first modified example of the fourth embodiment of the present disclosure includes a pair of jaws for performing a grip motion, that is, a first jaw1201 and a second jaw1202, and herein, each of the first jaw1201 and the second jaw1202 or a component encompassing the first jaw1201 and the second jaw1202 may be referred to as a jaw1203.

Meanwhile, the end tool1200 includes a plurality of pulleys including a pulley1211, a pulley1213, and a pulley1214 that are associated with a rotational motion of the first jaw1201. Meanwhile, the end tool1200 includes a plurality of pulleys including a pulley1221 associated with a rotational motion of the second jaw1202.

In addition, the end tool1200 of the first modified example of the fourth embodiment of the present disclosure may include a rotation shaft1241, a rotation shaft1243, and a rotation shaft1244. Here, the rotation shaft1241 may be inserted through an end tool hub1260, and the rotation shaft1243 and the rotation shaft1244 may be inserted through a pitch hub1250. The rotation shaft1241, the rotation shaft1243, and the rotation shaft1244 may be arranged sequentially from a distal end1204 toward a proximal end1205 of the end tool1200.

Further, the end tool1200 of the first modified example of the fourth embodiment of the present disclosure may include the end tool hub1260 and the pitch hub1250.

The rotation shaft1241 is inserted through the end tool hub1260, and the pulley1211 and the pulley1221, which are axially coupled to the rotation shaft1241, and at least some of the first jaw1201 and the second jaw1202 coupled the pulley1211 and the pulley1221 may be accommodated inside the end tool hub1260.

Meanwhile, a first pitch pulley portion1263aand a second pitch pulley portion1263b, which serve as end tool pitch pulleys, may be formed at one end portion of the end tool hub1260. A wire (see303 ofFIG.146) and a wire304 (see304 ofFIG.146) are coupled to the first pitch pulley portion1263aand the second pitch pulley portion1263b, which serve as end tool pitch pulleys, and a pitch motion is performed while the end tool hub1260 rotates around the rotation shaft1243.

The rotation shaft1243 and the rotation shaft1244 may be inserted through the pitch hub1250, and the pitch hub1250 may be axially coupled to the end tool hub1260 by the rotation shaft1243. Accordingly, the end tool hub1260 may be formed to be pitch-rotatable around the rotation shaft1243 with respect to the pitch hub1250.

Meanwhile, the end tool1200 of the fourth embodiment of the present disclosure may further include components such as a first electrode1251, a second electrode1252, a guide tube1271, and a blade1275 in order to perform a cauterizing motion and a cutting motion. Here, components related to the driving of the blade, such as the guide tube1271 and the blade1275, may be collectively referred to as a blade assembly. Components for performing a cauterizing motion and a cutting motion in the present embodiment are substantially the same as those described in the fourth embodiment, and thus a detailed description thereof will be omitted herein.

The surgical instrument for electrocautery according to the first modified example of the fourth embodiment of the present disclosure may include a wire301, a wire302, a wire303, a wire304, a wire305, a wire306, and a blade wire307, as in the fourth embodiment of the present disclosure described with reference toFIG.140 or the like.

Hereinafter, the actuation hub1290 of the first modified example of the fourth embodiment of the present disclosure will be described in more detail.

Referring toFIGS.185 to190, the actuation hub1290 may be formed in the form of a box having a hollow therein. Here, a first coupling hole1290ais formed in any one surface of the actuation hub1290, specifically, a surface coming into contact with the first jaw1201, and a second coupling hole1290bmay be formed in the other surface of the actuation hub1290, specifically, a surface coming into contact with the second jaw1202.

In this case, the first coupling hole1290amay be formed to be offset to a certain degree in one direction from the center line in the X-axis direction. In addition, the second coupling hole1290bmay be formed by being offset to a certain degree in another one direction from the center line in the X-axis direction.

In other words, it may be said that the first coupling hole1290aand the second coupling hole1290bare not on the same line in the Z-axis direction but are formed to be offset to a certain degree.

In addition, the actuation hub1290 is coupled to each of the first jaw1201 and the second jaw1202. In detail, a first actuation rotation shaft1291 is inserted through the first jaw1201 and the first coupling hole1290aof the actuation hub1290, so that the actuation hub1290 and the first jaw1201 are axially coupled. Further, a second actuation rotation shaft1292 is inserted through the second jaw1202 and the second coupling hole1290B of the actuation hub1290, so that the actuation hub1290 and the second jaw1202 are axially coupled.

Meanwhile, as described with reference toFIG.154 or the like, a tube seating portion, a wire through-hole, and a blade accommodation portion are sequentially formed inside the actuation hub1290, and the blade wire307 may pass through the inside of the actuation hub1290 to be connected to the blade1275.

As described above, by providing the actuation hub1290 to which the guide tube1270 is coupled between the first jaw1201 and the second jaw1202, the guide tube1270 may not be curved, or the angle at which the guide tube1270 is curved may be reduced, even when the first jaw1201 or the second jaw1202 rotates around the first rotation shaft1241 or the actuation rotation shaft1245.

In detail, in a case in which the guide tube1270 is directly coupled to the first jaw1201 or the second jaw1202, when the first jaw1201 or the second jaw1202 rotates, one end portion of the guide tube1270 also rotates together with the first jaw1201 or the second jaw1202, causing the guide tube1270 to be curved.

On the other hand, in a case in which the guide tube1270 is coupled to the actuation hub1290, which is independent of the rotation of the jaw1203, as in the present embodiment, even when the first jaw1201 or the second jaw1202 rotates, the guide tube1270 may not be curved, or the angle at which the guide tube1270 is curved may be reduced even when the guide tube1270 is curved.

That is, by changing the direct connection between the guide tube1270 and the jaw1203 by the actuation hub1290 to an indirect connection, the degree to which the guide tube1270 is curved by the rotation of the jaw1203 may be reduced.

In particular, in the end tool1200 of the first modified example of the fourth embodiment of the present disclosure, when the actuation hub1290 is coupled to the first jaw1201 and the second jaw1202, the first actuation rotation shaft1291 and the second actuation rotation shaft1292 are not on the same line in the Z-axis direction but are offset from each other to a certain degree. Thus, when the first jaw1201 and the second jaw1202 perform an actuation motion, the first actuation rotation shaft1291 and the second actuation rotation shaft1292 form a kind of two-point support, thereby obtaining an effect of more stably performing an actuation motion.

Second Modified Example of Fourth Embodiment

Hereinafter, an end tool1300 of a surgical instrument according to a second modified example of the fourth embodiment of the present disclosure will be described. Here, the end tool1300 of the surgical instrument according to the second modified example of the fourth embodiment of the present disclosure is different from the end tool (see1100 inFIG.140 or the like) of the surgical instrument according to the fourth embodiment of the present disclosure described above in that the configuration of an actuation hub1390 is different. The configuration changed from the fourth embodiment as described above will be described in detail later.

FIGS.191 to196 are views illustrating the end tool of the surgical instrument for electrocautery according to the second modified example of the fourth embodiment of the present disclosure.FIGS.197 and198 are views illustrating an actuation hub of the end tool of the surgical instrument for electrocautery ofFIG.191.FIG.199 is a perspective view illustrating a second jaw pulley of the end tool of the surgical instrument for electrocautery ofFIG.191.FIGS.200 and201 are views illustrating the end tool of the surgical instrument for electrocautery ofFIG.191.

Referring toFIGS.191 to201, the end tool1300 of the second modified example of the fourth embodiment of the present disclosure includes a pair of jaws for performing a grip motion, that is, a first jaw1301 and a second jaw1302, and herein, each of the first jaw1301 and the second jaw1302 or a component encompassing the first jaw1301 and the second jaw1302 may be referred to as a jaw1303.

Meanwhile, the end tool1300 includes a plurality of pulleys including a pulley1311, a pulley1313, and a pulley1314 associated with a rotational motion of a first jaw1301. Meanwhile, the end tool1300 includes a plurality of pulleys including a pulley1321 associated with a rotational motion of the second jaw1302.

In addition, the end tool1300 of the second modified example of the fourth embodiment of the present disclosure may include a rotation shaft1341, a rotation shaft1343, and a rotation shaft1344. Here, the rotation shaft1341 may be inserted through an end tool hub1360, and the rotation shaft1343 and the rotation shaft1344 may be inserted through a pitch hub1350.

In addition, the end tool1300 of the second modified example of the fourth embodiment of the present disclosure may include the end tool hub1360 and the pitch hub1350.

Meanwhile, the end tool1300 of the second modified example of the fourth embodiment of the present disclosure may further include components such as a first electrode1351, a second electrode1352, a guide tube1371, and a blade1375 in order to perform a cauterizing motion and a cutting motion.

The surgical instrument for electrocautery according to the second modified example of the fourth embodiment of the present disclosure may include a wire301, a wire302, a wire303, a wire304, a wire305, a wire306, and a blade wire307, as in the fourth embodiment of the present disclosure described with reference toFIG.140 or the like.

Since components of the present modified example described above are substantially the same as the components described in the fourth embodiment, a detailed description thereof will be omitted herein.

Hereinafter, the actuation hub1390 of the second modified example of the fourth embodiment of the present disclosure will be described in more detail.

Referring toFIGS.191 to201, the actuation hub1390 may be formed in the form of a box having a hollow therein.

Here, a first coupling hole1390ais formed in any one surface of the actuation hub1390, specifically, a surface coming into contact with the first jaw1301, and a second coupling hole1390bmay be formed in the other surface of the actuation hub1390, specifically, a surface coming into contact with the second jaw1302.

In this case, the first coupling hole1390amay be formed to be offset to a certain degree in one direction from the center line in the X-axis direction. In addition, the second coupling hole1390bmay be formed by being offset to a certain degree in another one direction from the center line in the X-axis direction.

In other words, it may be said that the first coupling hole1390aand the second coupling hole1390bare not on the same line in the Z-axis direction but are formed to be offset to a certain degree.

In addition, the actuation hub1390 is coupled to each of the first jaw1301 and the second jaw1302. In detail, a first actuation rotation shaft1391 is inserted through the first jaw1301 and the first coupling hole1390aof the actuation hub1390, so that the actuation hub1390 and the first jaw1301 are axially coupled. Further, a second actuation rotation shaft1392 is inserted through the second jaw1302 and the second coupling hole1390bof the actuation hub1390, so that the actuation hub1390 and the second jaw1302 are axially coupled.

Meanwhile, as described with reference toFIG.154 or the like, a tube seating portion, a wire through-hole, and a blade accommodation portion are sequentially formed inside the actuation hub1390, and the blade wire307 may pass through the inside of the actuation hub1390 to be connected to the blade1375.

In addition, a guide slit1390cmay be formed in any one surface of the actuation hub1390 or in both surfaces thereof in a longitudinal direction thereof (i.e., the X-axis direction). In addition, a slit coupling portion1321cformed on the pulley1321 may be fitted into the guide slit1390c, so that a linear movement of the pulley1321 in the X-axis direction may be guided by the guide slit1390c.

In detail, a shaft coupling portion1321a, a jaw coupling portion1321b, and the slit coupling portion1321cmay be formed on the pulley1321. Here, the shaft coupling portion1321aand the jaw coupling portion1321bmay be formed in the same manner as described in the fourth embodiment or the like. The slit coupling portion1321cmay be formed to protrude to a certain degree further from the shaft coupling portion1321a. The above-described slit coupling portion1321cis fitted into the guide slit1390cof the actuation hub1390.

Meanwhile, although not shown in the drawings, a slit coupling portion (not shown) may also be formed in the pulley1311.

As described above, by providing the actuation hub1390 to which the guide tube1370 is coupled between the first jaw1301 and the second jaw1302, the guide tube1370 may not be curved, or the angle at which the guide tube1370 is curved may be reduced, even when the first jaw1301 or the second jaw1302 rotates around the first rotation shaft1341 or the actuation rotation shaft1345.

In detail, in a case in which the guide tube1370 is directly coupled to the first jaw1301 or the second jaw1302, when the first jaw1301 or the second jaw1302 rotates, one end portion of the guide tube1370 also rotates together with the first jaw1301 or the second jaw1302, causing the guide tube1370 to be curved.

On the other hand, in a case in which the guide tube1370 is coupled to the actuation hub1390, which is independent of the rotation of the jaw1303, as in the present embodiment, even when the first jaw1301 or the second jaw1302 rotates, the guide tube1370 may not be curved, or the angle at which the guide tube1370 is curved may be reduced even when the guide tube1370 is curved.

That is, by changing the direct connection between the guide tube1370 and the jaw1303 by the actuation hub1390 to an indirect connection, the degree to which the guide tube1370 is curved by the rotation of the jaw1303 may be reduced.

In particular, in the end tool1300 of the second modified example of the fourth embodiment of the present disclosure, when the actuation hub1390 is coupled to the first jaw1301 and the second jaw1302, the first actuation rotation shaft1391 and the second actuation rotation shaft1392 are not on the same line in the Z-axis direction but are offset to a certain degree. Thus, when the first jaw1301 and the second jaw1302 perform an actuation motion, the first actuation rotation shaft1391 and the second actuation rotation shaft1392 form a kind of two point support, thereby obtaining an effect of more stably performing an actuation motion.

In addition, in the end tool1300 of the second modified example of the fourth embodiment of the present disclosure, the slit coupling portion1321cformed on the pulley1321 is fitted into the guide slit1390cof the actuation hub1390 so that the linear movement of the pulley1321 in the X-axis direction may be guided by the guide slit1390c. That is, when the first jaw1301 and the second jaw1302 perform an actuation motion, the first jaw1301 and the second jaw1302 move along the guide slit1390cof the actuation hub1390, thereby obtaining an effect of more stably performing the actuation motion.

Third Modified Example of Fourth Embodiment

Hereinafter, an end tool1400 of a surgical instrument according to a third modified example of the fourth embodiment of the present disclosure will be described. Here, the end tool1400 of the surgical instrument according to the third modified example of the fourth embodiment of the present disclosure is different from the end tool (see1100 inFIG.140 or the like) of the surgical instrument according to the fourth embodiment of the present disclosure described above in that the configuration of an actuation hub1490 is different. The configuration changed from the fourth embodiment as described above will be described in detail later.

FIGS.202 to205 are views illustrating the end tool of the surgical instrument for electrocautery according to the third modified example of the fourth embodiment of the present disclosure.FIGS.206 and207 are views illustrating an actuation hub of the end tool of the surgical instrument for electrocautery ofFIG.202.FIG.208 is a perspective view illustrating a second jaw pulley of the end tool of the surgical instrument for electrocautery ofFIG.202.

Referring toFIGS.202 to208, the end tool1400 of the third modified example of the fourth embodiment of the present disclosure includes a pair of jaws for performing a grip motion, that is, a first jaw1401 and a second jaw1402, and herein, each of the first jaw1401 and the second jaw1402 or a component encompassing the first jaw1401 and the second jaw1402 may be referred to as a jaw1403.

Meanwhile, the end tool1400 includes a plurality of pulleys including a pulley1411, a pulley1413, and a pulley1414 that are associated with a rotational motion of the first jaw1401. Meanwhile, the end tool1400 includes a plurality of pulleys including a pulley1421 associated with a rotational motion of the second jaw1402.

In addition, the end tool1400 of the third modified example of the fourth embodiment of the present disclosure may include a rotation shaft1441, a rotation shaft1443, and a rotation shaft1444. Here, the rotation shaft1441 may be inserted through an end tool hub1460, and the rotation shaft1443 and the rotation shaft1444 may be inserted through a pitch hub1450.

In addition, the end tool1400 of the third modified example of the fourth embodiment of the present disclosure may include the end tool hub1460 and the pitch hub1450.

Meanwhile, the end tool1400 of the third modified example of the fourth embodiment of the present disclosure may further include components such as a first electrode1451, a second electrode1452, a guide tube1471, and a blade1475 in order to perform a cauterizing motion and a cutting motion.

The surgical instrument for electrocautery according to the third modified example of the fourth embodiment of the present disclosure may include a wire301, a wire302, a wire303, a wire304, a wire305, a wire306, and a blade wire307, as in the fourth embodiment of the present disclosure described with reference toFIG.140 or the like.

Since components of the present modified example described above are substantially the same as the components described in the fourth embodiment, a detailed description thereof will be omitted herein.

Hereinafter, the actuation hub1490 of the third modified example of the fourth embodiment of the present disclosure will be described in more detail.

Referring toFIGS.202 to208, the actuation hub1490 may be formed in the form of a box having a hollow therein.

Here, a first coupling hole1490ais formed in any one surface of the actuation hub1490, specifically, a surface coming into contact with the first jaw1401, and a second coupling hole1490bmay be formed in the other surface of the actuation hub1490, specifically, a surface coming into contact with the second jaw1402.

Here, the first coupling hole1490aand the second coupling hole1490bmay be located on the same line in the Z-axis direction.

In addition, the actuation hub1490 is coupled to each of the first jaw1401 and the second jaw1402. In detail, a first actuation rotation shaft1491 is inserted through the first jaw1401 and the first coupling hole1490aof the actuation hub1490, so that the actuation hub1490 and the first jaw1401 are axially coupled. Further, a second actuation rotation shaft1492 is inserted through the second jaw1402 and the second coupling hole1490bof the actuation hub1490, so that the actuation hub1490 and the second jaw1402 are axially coupled.

Meanwhile, as described with reference toFIG.154 or the like, a tube seating portion, a wire through-hole, and a blade accommodation portion are sequentially formed inside the actuation hub1490, and the blade wire307 may pass through the inside of the actuation hub1490 to be connected to the blade1475.

In addition, a guide slit1490cmay be formed in any one surface of the actuation hub1490 or in both surfaces thereof in a longitudinal direction thereof (i.e., the X-axis direction). In addition, a slit coupling portion1421cformed on the pulley1421 may be fitted into the guide slit1490c, so that a linear movement of the pulley1421 in the X-axis direction may be guided by the guide slit1490c.

In detail, a shaft coupling portion1421a, a jaw coupling portion1421b, and the slit coupling portion1421cmay be formed on the pulley1421. Here, the shaft coupling portion1421aand the jaw coupling portion1421bmay be formed in the same manner as described in the fourth embodiment or the like. The slit coupling portion1421cmay be formed to protrude to a certain degree further from the shaft coupling portion1421a. The above-described slit coupling portion1421cis fitted into the guide slit1490cof the actuation hub1490.

Meanwhile, although not shown in the drawings, a slit coupling portion (not shown) may also be formed in the pulley1411.

As described above, by providing the actuation hub1490 to which the guide tube1470 is coupled between the first jaw1401 and the second jaw1402, the guide tube1470 may not be curved, or the angle at which the guide tube1470 is curved may be reduced, even when the first jaw1401 or the second jaw1402 rotates around the first rotation shaft1441 or the actuation rotation shaft1445.

In detail, in a case in which the guide tube1470 is directly coupled to the first jaw1401 or the second jaw1402, when the first jaw1401 or the second jaw1402 rotates, one end portion of the guide tube1470 also rotates together with the first jaw1401 or the second jaw1402, causing the guide tube1470 to be curved.

On the other hand, in a case in which the guide tube1470 is coupled to the actuation hub1490, which is independent of the rotation of the jaw1403, as in the present embodiment, even when the first jaw1401 or the second jaw1402 rotates, the guide tube1470 may not be curved, or the angle at which the guide tube1470 is curved may be reduced even when the guide tube1470 is curved.

That is, by changing the direct connection between the guide tube1470 and the jaw1403 by the actuation hub1490 to an indirect connection, the degree to which the guide tube1470 is curved by the rotation of the jaw1403 may be reduced.

In addition, in the end tool1400 of the third modified example of the fourth embodiment of the present disclosure, the slit coupling portion1421cformed on the pulley1421 is fitted into the guide slit1490cof the actuation hub1490 so that the linear movement of the pulley1421 in the X-axis direction may be guided by the guide slit1490c. That is, when the first jaw1401 and the second jaw1402 perform an actuation motion, the first jaw1401 and the second jaw1402 move along the guide slit1490cof the actuation hub1490, thereby obtaining an effect of more stably performing the actuation motion.

Fourth Modified Example of Fourth Embodiment

Hereinafter, an end tool1500 of a surgical instrument according to a fourth modified example of the fourth embodiment of the present disclosure will be described. Here, the end tool1500 of the surgical instrument according to the fourth modified example of the fourth embodiment of the present disclosure is different from the end tool (see1100 inFIG.140 or the like) of the surgical instrument according to the fourth embodiment of the present disclosure described above in that the configuration of an actuation hub1590 is different. The configuration changed from the fourth embodiment as described above will be described in detail later.

FIGS.209 to213 are views illustrating the end tool of the surgical instrument for electrocautery according to the fourth modified example of the fourth embodiment of the present disclosure.FIGS.214 and215 are views illustrating an actuation hub of the end tool of the surgical instrument for electrocautery ofFIG.209.

Referring toFIGS.209 to215, the end tool1500 of the fourth modified example of the fourth embodiment of the present disclosure includes a pair of jaws for performing a grip motion, that is, a first jaw1501 and a second jaw1502, and herein, each of the first jaw1501 and the second jaw1502 or a component encompassing the first jaw1501 and the second jaw1502 may be referred to as a jaw1503.

Meanwhile, the end tool1500 includes a plurality of pulleys including a pulley1511 and a pulley1513, and a pulley1514 that are associated with a rotational motion of the first jaw1501. Meanwhile, the end tool1500 includes a plurality of pulleys including a pulley1521 associated with a rotational motion of the second jaw1502.

In addition, the end tool1500 of the fourth modified example of the fourth embodiment of the present disclosure may include a rotation shaft1541, a rotation shaft1543, and a rotation shaft1544. Here, the rotation shaft1541 may be inserted through an end tool hub1560, and the rotation shaft1543 and the rotation shaft1544 may be inserted through a pitch hub1550. The rotation shaft1541, the rotation shaft1543, and the rotation shaft1544 may be arranged sequentially from a distal end1504 toward a proximal end1505 of the end tool1500.

In addition, the end tool1500 of the fourth modified example of the fourth embodiment of the present disclosure may include the end tool hub1560 and the pitch hub1550.

The rotation shaft1541 is inserted through the end tool hub1560, and the pulley1511 and the pulley1521, which are axially coupled to the rotation shaft1541, and at least some of the first jaw1501 and the second jaw1502 coupled the pulley1511 and the pulley1521 may be accommodated inside the end tool hub1560.

Meanwhile, a first pitch pulley portion1563aand a second pitch pulley portion1563b, which serve as end tool pitch pulleys, may be formed at one end portion of the end tool hub1560. A wire (see303 ofFIG.146) and a wire304 (see304 ofFIG.146) are coupled to the first pitch pulley portion1563aand the second pitch pulley portion1563b, which serve as end tool pitch pulleys, and a pitch motion is performed while the end tool hub1560 rotates around the rotation shaft1543.

The rotation shaft1543 and the rotation shaft1544 may be inserted through the pitch hub1550, and the pitch hub1550 may be axially coupled to the end tool hub1560 by the rotation shaft1543. Accordingly, the end tool hub1560 may be formed to be pitch-rotatable around the rotation shaft1543 with respect to the pitch hub1550.

Meanwhile, the end tool1500 of the fourth modified example of the fourth embodiment of the present disclosure may further include components such as a first electrode1551, a second electrode1552, a guide tube1571, and a blade1575 in order to perform a cauterizing motion and a cutting motion. Here, components related to the driving of the blade, such as the guide tube1571 and the blade1575, may be collectively referred to as a blade assembly. Components for performing a cauterizing motion and a cutting motion in the present embodiment are substantially the same as those described in the fourth embodiment, and thus a detailed description thereof will be omitted herein.

The surgical instrument for electrocautery according to the fourth modified example of the fourth embodiment of the present disclosure may include a wire301, a wire302, a wire303, a wire304, a wire305, a wire306, and a blade wire307, as in the fourth embodiment of the present disclosure described with reference toFIG.140 or the like.

Hereinafter, the actuation hub1590 of the fourth modified example of the fourth embodiment of the present disclosure will be described in more detail.

Referring toFIGS.209 to215, the actuation hub1590 may be formed in the form of a box having a hollow therein. Here, a first coupling hole1590ais formed in any one surface of the actuation hub1590, specifically, a surface coming into contact with the first jaw1501, and a second coupling hole1590bmay be formed in the other surface of the actuation hub1590, specifically, a surface coming into contact with the second jaw1502. Here, the first coupling hole1590aand the second coupling hole1590bmay be disposed on the same line in the Z-axis direction.

In addition, the actuation hub1590 is coupled to each of the first jaw1501 and the second jaw1502. In detail, a first actuation rotation shaft1591 is inserted through the first jaw1501 and the first coupling hole1590aof the actuation hub1590, so that the actuation hub1590 and the first jaw1501 are axially coupled. Further, a second actuation rotation shaft1592 is inserted through the second jaw1502 and the second coupling hole1590bof the actuation hub1590, so that the actuation hub1590 and the second jaw1502 are axially coupled.

Meanwhile, as described with reference toFIG.154 or the like, a tube seating portion, a wire through-hole, and a blade accommodation portion are sequentially formed inside the actuation hub1590, and the blade wire307 may pass through the inside of the actuation hub1590 to be connected to the blade1575.

As described above, by providing the actuation hub1590 to which the guide tube1570 is coupled between the first jaw1501 and the second jaw1502, the guide tube1570 may not be curved, or the angle at which the guide tube1570 is curved may be reduced, even when the first jaw1501 or the second jaw1502 rotates around the first rotation shaft1541 or the actuation rotation shaft1545.

In detail, in a case in which the guide tube1570 is directly coupled to the first jaw1501 or the second jaw1502, when the first jaw1501 or the second jaw1502 rotates, one end portion of the guide tube1570 also rotates together with the first jaw1501 or the second jaw1502, causing the guide tube1570 to be curved.

On the other hand, in a case in which the guide tube1570 is coupled to the actuation hub1590, which is independent of the rotation of the jaw1503, as in the present embodiment, even when the first jaw1501 or the second jaw1502 rotates, the guide tube1570 may not be curved, or the angle at which the guide tube1570 is curved may be reduced even when the guide tube1570 is curved.

That is, by changing the direct connection between the guide tube1570 and the jaw1503 by the actuation hub1590 to an indirect connection, the degree to which the guide tube1570 is curved by the rotation of the jaw1503 may be reduced.

As such, the present disclosure has been described with reference to the embodiments described with reference to the drawings, but it will be understood that this is merely exemplary, and those of ordinary skill in the art will understand that various modifications and variations of the embodiments are possible therefrom. Accordingly, the true technical protection scope of the present disclosure should be defined by the technical spirit of the appended claims.

Advantageous Effects of Disclosure

According to the present disclosure, a manipulation direction of a manipulation portion by an operator and an operating direction of an end tool are intuitively identical to each other, so that the operator's convenience can be improved, and the accuracy, reliability and speed of surgery can be improved.

BRIEF DESCRIPTION OF DRAWINGS

FIG.1A is a conceptual diagram of a pitch motion of a conventional surgical instrument, andFIG.1B is a conceptual diagram of a yaw motion thereof.

FIG.1C is a conceptual diagram of a pitch motion of another conventional surgical instrument, andFIG.1D is a conceptual diagram of a yaw motion thereof.

FIG.1E is a conceptual diagram of a pitch motion of a surgical instrument according to the present disclosure, andFIG.1F is a conceptual diagram of a yaw motion thereof.

FIG.2 is a perspective view illustrating a surgical instrument for electrocautery according to a first embodiment of the present disclosure.

FIGS.3,4,5, and6 are perspective views illustrating an end tool of the surgical instrument for electrocautery ofFIG.2.

FIGS.7 and8 are plan views illustrating the end tool of the surgical instrument for electrocautery ofFIG.2.

FIG.9 is a perspective view illustrating an end tool hub of the surgical instrument for electrocautery ofFIG.2.

FIGS.10 and11 are cut-away perspective views of the end tool hub ofFIG.9.

FIGS.12 and13 are perspective views illustrating the end tool hub ofFIG.9.

FIG.14 is a side view illustrating the end tool hub ofFIG.9 and a guide tube.

FIG.15 is a plan view illustrating the end tool hub ofFIG.9 and the guide tube.

FIGS.16 and17 are plan views illustrating an opening and closing motion of the end tool of the surgical instrument for electrocautery ofFIG.2.

FIGS.18 to20 are partial cross-sectional views illustrating an operation of a blade of the end tool of the surgical instrument for electrocautery ofFIG.2.

FIGS.21 and22 are bottom views illustrating a process of performing an opening and closing motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.2 is yaw-rotated by −90°.

FIGS.23 and24 are bottom views illustrating a process of performing an opening and closing motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.2 is yaw-rotated by +90°.

FIGS.25 and26 are views illustrating a path of the guide tube and a movement path of the blade during a cutting motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.2 is yaw-rotated by +90°.

FIGS.27 and28 are views illustrating a process of performing an opening and closing motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.2 is pitch-rotated by −90°.

FIGS.29 and30 are views illustrating a process of performing an opening and closing motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.2 is pitch-rotated by +90°.

FIG.31 is a view illustrating a path of the guide tube in a state in which the end tool of the surgical instrument for electrocautery ofFIG.2 is pitch-rotated by −90°.

FIGS.32 and33 are views illustrating a path of the guide tube and a movement path of the blade during a cutting motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.2 is pitch-rotated by −90°.

FIG.34 is a perspective view illustrating the surgical instrument for electrocautery ofFIG.2 in a pitch-rotated and yaw-rotated state.

FIGS.35 to37 are views illustrating the end tool of the surgical instrument for electrocautery ofFIG.2 performing a cutting motion in a state in which the end tool is pitch-rotated by −90° and simultaneously yaw-rotated by +90°.

FIGS.38 to40 are views illustrating an end tool of a surgical instrument for electrocautery according to a modified example of the first embodiment of the present disclosure.

FIG.41 is a perspective view illustrating a surgical instrument for electrocautery according to a second embodiment of the present disclosure.

FIGS.42 to47 are views illustrating an end tool of the surgical instrument for electrocautery ofFIG.41.

FIG.48 is a perspective view illustrating an end tool hub of the surgical instrument for electrocautery ofFIG.41.

FIGS.49 and50 are cut-away perspective views of the end tool hub ofFIG.48.

FIGS.51 and52 are perspective views illustrating the end tool hub ofFIG.48.

FIG.53 is a side view illustrating the end tool hub ofFIG.48 and a guide tube.

FIG.54 is a plan view illustrating the end tool hub ofFIG.48 and the guide tube.

FIG.55 is a perspective view illustrating a first jaw of the end tool of the surgical instrument for electrocautery ofFIG.41.

FIG.56 is a perspective view illustrating a second jaw of the end tool of the surgical instrument for electrocautery ofFIG.41.

FIG.57 is a perspective view illustrating a first jaw pulley of the end tool of the surgical instrument for electrocautery ofFIG.41.

FIG.58 is a plan view illustrating an opening and closing motion of the first jaw of the end tool of the surgical instrument for electrocautery ofFIG.41.

FIG.59 is a plan view illustrating an opening and closing motion of the second jaw of the end tool of the surgical instrument for electrocautery ofFIG.41.

FIG.60 is a plan view illustrating an opening and closing motion of the first jaw and the second jaw of the end tool of the surgical instrument for electrocautery ofFIG.41.

FIGS.61 and62 are plan views illustrating an opening and closing motion of the first jaw and the second jaw in response to an actuation motion of the end tool of the surgical instrument for electrocautery ofFIG.41.

FIGS.63 to65 are partial cross-sectional view illustrating an operation of a blade of the end tool of the surgical instrument for electrocautery ofFIG.41.

FIGS.66 and67 are views illustrating a process of performing an opening and closing motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.41 is yaw-rotated by +90°.

FIGS.68 and69 are views illustrating a process of performing an opening and closing motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.41 is yaw-rotated by −90°.

FIGS.70 and71 are views illustrating a path of the guide tube and a movement path of the blade during a cutting motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.41 is yaw-rotated by +90°.

FIGS.72 and73 are views illustrating a process of performing an opening and closing motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.41 is pitch-rotated by −90°.

FIGS.74 and75 are views illustrating a process of performing an opening and closing motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.41 is pitch-rotated by +90°.

FIG.76 is a view illustrating a path of the guide tube in a state in which the end tool of the surgical instrument for electrocautery ofFIG.41 is pitch-rotated by −90°.

FIGS.77 and78 are views illustrating a path of the guide tube and a movement path of the blade during a cutting motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.41 is pitch-rotated by −90°.

FIG.79 is a perspective view illustrating the surgical instrument for electrocautery ofFIG.41 in a pitch-rotated and yaw-rotated state.

FIGS.80 to82 are views illustrating the end tool of the surgical instrument for electrocautery ofFIG.41 performing a cutting motion in a state in which the end tool is pitch-rotated by −90° and simultaneously yaw-rotated by +90°.

FIGS.83 to85 are views illustrating an end tool of a surgical instrument for electrocautery according to a modified example of the second embodiment of the present disclosure.

FIG.86 is a perspective view illustrating a surgical instrument for electrocautery according to a third embodiment of the present disclosure.

FIGS.87 to92 are views illustrating an end tool of the surgical instrument for electrocautery ofFIG.86.

FIG.93 is a perspective view illustrating a yaw hub of the end tool of the surgical instrument for electrocautery ofFIG.86.

FIG.94 is cut-away perspective view illustrating the yaw hub of the end tool of the surgical instrument for electrocautery ofFIG.86.

FIGS.95 and96 are perspective views illustrating the yaw hub of the end tool of the surgical instrument for electrocautery ofFIG.86.

FIGS.97 and98 are perspective views illustrating an actuation pulley of the end tool of the surgical instrument for electrocautery ofFIG.86 and wires.

FIGS.99 and100 are perspective views illustrating the actuation pulley of the end tool of the surgical instrument for electrocautery ofFIG.86.

FIG.101 is a perspective view illustrating an actuation link of the end tool of the surgical instrument for electrocautery ofFIG.86.

FIGS.102 to104 are views illustrating an opening and closing motion of a first jaw and a second jaw of the end tool of the surgical instrument for electrocautery ofFIG.86.

FIGS.105 to108 are perspective views illustrating an actuation motion of the end tool of the surgical instrument for electrocautery ofFIG.86.

FIGS.109 to111 are partial cross-sectional views illustrating an operation of a blade of the end tool of the surgical instrument for electrocautery ofFIG.86.

FIGS.112 and113 are bottom views illustrating a process of performing an opening and closing motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.86 is yaw-rotated by +90°.

FIGS.114 and115 are bottom views illustrating a process of performing an opening and closing motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.86 is yaw-rotated by +90°.

FIGS.116 to119 are views illustrating a path of a guide tube and a movement path of the blade during a cutting motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.86 is yaw-rotated by +90°.

FIGS.120 to123 are views illustrating the actuation link and the guide tube in a state in which the end tool of the surgical instrument for electrocautery ofFIG.86 is yaw-rotated by +90°.

FIGS.124 and125 are views illustrating the actuation link and the guide tube in a state in which the end tool of the surgical instrument for electrocautery ofFIG.86 is yaw-rotated by +90°.

FIGS.126 and127 are views illustrating a process of performing an opening and closing motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.86 is pitch-rotated by −90°.

FIGS.128 and129 are views illustrating a process of performing an opening and closing motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.86 is pitch-rotated by +90°.

FIG.130 is a view illustrating a path of the guide tube in a state in which the end tool of the surgical instrument for electrocautery ofFIG.86 is pitch-rotated by −90°.

FIGS.131 and132 are views illustrating a path of the guide tube and a movement path of the blade during a cutting motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.86 is pitch-rotated by +90°.

FIG.133 is a perspective view illustrating the surgical instrument for electrocautery ofFIG.86 in a pitch-rotated and yaw-rotated state.

FIGS.134 to136 are views illustrating the end tool of the surgical instrument for electrocautery ofFIG.86 performing a cutting motion in a state in which the end tool is pitch-rotated by −90° and simultaneously yaw-rotated by +90°.

FIGS.137 to139 are views illustrating an end tool of a surgical instrument for electrocautery according to a modified example of the third embodiment of the present disclosure.

FIG.140 is a perspective view illustrating a surgical instrument for electrocautery according to a fourth embodiment of the present disclosure.

FIGS.141 to146 are views illustrating an end tool of the surgical instrument for electrocautery ofFIG.140.

FIG.147 is a perspective view illustrating an end tool hub of the surgical instrument for electrocautery ofFIG.140.

FIGS.148 and149 are cut-away perspective views of the end tool hub ofFIG.147.

FIGS.150 and151 are perspective views illustrating the end tool hub ofFIG.147.

FIG.152 is a side view illustrating the end tool hub ofFIG.147 and a guide tube.

FIG.153 is a plan view illustrating the end tool hub ofFIG.147 and the guide tube.

FIGS.154A and154B are a perspective view and a cut-away perspective view illustrating an actuation hub of the surgical instrument for electrocautery ofFIG.147 ofFIG.140.

FIG.155 is a view illustrating a state in which the guide tube, a blade wire, and a blade are mounted on the actuation hub illustrated in the cut-away perspective view ofFIG.154.

FIG.156 is an exploded perspective view illustrating the end tool of the surgical instrument for electrocautery ofFIG.140.

FIG.157 is a perspective view illustrating a first jaw of the end tool of the surgical instrument for electrocautery ofFIG.140.

FIG.158 is a perspective view illustrating a second jaw of the end tool of the surgical instrument for electrocautery ofFIG.140.

FIG.159 is a perspective view illustrating a first jaw pulley of the surgical instrument for electrocautery ofFIG.140.

FIG.160 is a plan view illustrating an opening and closing motion of the first jaw of the end tool of the surgical instrument for electrocautery ofFIG.140.

FIG.161 is a plan view illustrating an opening and closing motion of the second jaw of the end tool of the surgical instrument for electrocautery ofFIG.140.

FIG.162 is a plan view illustrating an opening and closing motion of the first jaw and the second jaw of the end tool of the surgical instrument for electrocautery ofFIG.140.

FIGS.163 and164 are plan views illustrating an opening and closing motion of the end tool of the surgical instrument for electrocautery ofFIG.140.

FIGS.165 to167 are partial cross-sectional views illustrating an operation of the blade of the end tool of the surgical instrument for electrocautery ofFIG.140.

FIGS.168 and169 are views illustrating a process of performing an opening and closing motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.140 is yaw-rotated by −90°.

FIGS.170 and171 are bottom views illustrating a process of performing an opening and closing motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.140 is yaw-rotated by +90°.

FIGS.172 and173 are views illustrating a path of the guide tube and a movement path of a blade during a cutting motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.140 is yaw-rotated.

FIGS.174 and175 are views illustrating a process of performing an opening and closing motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.140 is pitch-rotated by +90°.

FIGS.176 and177 are views illustrating a process of performing an opening and closing motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.140 is pitch-rotated by −90°.

FIG.178 is a view illustrating a path of the guide tube in a state in which the end tool of the surgical instrument for electrocautery ofFIG.140 is pitch-rotated by −90°.

FIGS.179 and180 are views illustrating a path of the guide tube and a movement path of the blade during a cutting motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.140 is pitch-rotated by −90°.

FIG.181 is a perspective view illustrating the surgical instrument for electrocautery ofFIG.140 in a pitch-rotated and yaw-rotated state.

FIGS.182 to184 are views illustrating the end tool of the surgical instrument for electrocautery ofFIG.140 performing a cutting motion in a state in which the end tool is pitch-rotated by −90° and simultaneously yaw-rotated by +90°.

FIGS.185 and186 are perspective views illustrating an end tool of a surgical instrument for electrocautery according to a first modified example of the fourth embodiment of the present disclosure.

FIGS.187 and188 are plan views illustrating the end tool of the surgical instrument for electrocautery according to the first modified example of the fourth embodiment of the present disclosure.

FIGS.189 and190 are views illustrating an actuation hub of the surgical instrument for electrocautery according to the first modified example of the fourth embodiment of the present disclosure.

FIGS.191 to196 are views illustrating an end tool of a surgical instrument for electrocautery according to a second modified example of the fourth embodiment of the present disclosure.

FIGS.197 and198 are views illustrating an actuation hub of the end tool of the surgical instrument for electrocautery ofFIG.191.

FIG.199 is a perspective view illustrating a second jaw pulley of the end tool of the surgical instrument for electrocautery ofFIG.191.

FIGS.200 and201 are views illustrating the end tool of the surgical instrument for electrocautery ofFIG.191.

FIGS.202 to205 are views illustrating an end tool of a surgical instrument for electrocautery according to a third modified example of the fourth embodiment of the present disclosure.

FIGS.206 and207 are views illustrating an actuation hub of the end tool of the surgical instrument for electrocautery ofFIG.202.

FIG.208 is a perspective view illustrating a second jaw pulley of the end tool of the surgical instrument for electrocautery ofFIG.202.

FIGS.209 to213 are views illustrating an end tool of a surgical instrument for electrocautery according to a fourth modified example of the fourth embodiment of the present disclosure.

FIGS.214 and215 are views illustrating an actuation hub of the end tool of the surgical instrument for electrocautery ofFIG.209.

FIGS.216 and217 are perspective views illustrating a manipulation portion of the surgical instrument for electrocautery ofFIG.140.

FIG.218 is a view schematically illustrating only a configuration of pulleys and wires constituting joints of the surgical instrument for electrocautery illustrated inFIG.140.

FIG.219 is a perspective view illustrating a yaw motion of the surgical instrument for electrocautery ofFIG.140.

FIGS.220 and221 are diagrams illustrating a configuration of pulleys and wires, which are associated with an actuation motion and a yaw motion of the surgical instrument for electrocautery illustrated inFIG.140, in detail for each of the first jaw and the second jaw.

FIG.222 is a perspective view illustrating a pitch motion of the surgical instrument for electrocautery ofFIG.140.

FIGS.223 and224 are diagrams illustrating a configuration of pulleys and wires, which are associated with a pitch motion of the surgical instrument for electrocautery illustrated inFIG.140, in detail for each of the first jaw and the second jaw.

MODE OF DISCLOSURE

As the present disclosure allows for various changes and numerous embodiments, example embodiments will be illustrated in the drawings and described in detail. However, this is not intended to limit the present disclosure to particular modes of practice, and it is to be appreciated that all modifications, equivalents, and/or alternatives that do not depart from the spirit and technical scope are encompassed in the disclosure. In the description of embodiments, certain detailed explanations of the related art are omitted when they are deemed as unnecessarily obscuring the essence of the present disclosure.

While such terms as “first,” “second,” etc., may be used to describe various components, such components must not be limited by the above terms. The above terms are used only to distinguish one component from another.

The terms used in the present application are merely used to describe example embodiments, and are not intended to limit the present disclosure. As used herein, the singular forms “a,” “an” and “the” are intended to include the plural forms as well, unless the context clearly indicates otherwise. In the present specification, it is to be understood that the terms such as “including,” “having,” and “comprising” are intended to indicate the existence of the features, numbers, steps, actions, components, parts, or combinations thereof disclosed in the specification, and are not intended to preclude the possibility that one or more other features, numbers, steps, actions, components, parts, or combinations thereof may exist or may be added.

Hereinafter, embodiments of the present disclosure are described in detail with reference to the attached drawings. Like or corresponding reference numerals in the drawings denote like elements, and any redundant descriptions thereon will be omitted.

In addition, in describing various embodiments of the present disclosure, each embodiment does not have to be interpreted or practiced independently, and It should be understood that the technical concepts described in each embodiment may be interpreted or implemented in combination with other embodiments described individually.

In the surgical instrument for electrocautery according to the present disclosure, with respect to one or more motions from a pitch motion, a yaw motion, and an actuation motion, when a manipulation portion is rotated in one direction, an end tool may rotate in a direction intuitively the same as the manipulation direction of the manipulation portion.

(a) ofFIG.1 is a conceptual diagram of pitch motion of a conventional surgical instrument, and (b) ofFIG.1 is a conceptual diagram of yaw motion.

With reference to (a) ofFIG.1, in performing a pitch motion of a conventional surgical instrument, with an end tool120aformed in front of a rotation center121aof the end tool120aand a manipulation portion110aformed behind a rotation center111aof the manipulation portion110a, when the manipulation portion110ais rotated in the clockwise direction, the end tool120amay also be rotated in the clockwise direction, and when the manipulation portion110ais rotated in the counterclockwise direction, the end tool120amay also be rotated in the counterclockwise direction. With reference to (b) ofFIG.1, in performing a yaw motion of a conventional surgical instrument, with the end tool120aformed in front of the rotation center121aof the end tool120aand the manipulation portion110aformed behind the rotation center111aof the manipulation portion110a, when the manipulation portion110ais rotated in the clockwise direction, the end tool120amay also be rotated in the clockwise direction, and when the manipulation portion110ais rotated in the counterclockwise direction, the end tool120amay also be rotated in the counterclockwise direction. In this case, from the viewpoint of left and right sides of a user, when the user moves the manipulation portion110ato the left, the end tool120amay move to the right, and when the user moves the manipulation portion110ato the right, the end tool120amay move to the left. As a result, as the user manipulation direction is opposite to the end tool operation direction, the user may make a mistake, and have difficulty in manipulating the instrument.

(c) ofFIG.1 is a conceptual diagram of pitch motion of another conventional surgical instrument, and (d) ofFIG.1 is a conceptual diagram of yaw motion.

With reference to (c) ofFIG.1, some of the conventional surgical instruments may be formed in a mirror-symmetrical manner, and in performing a pitch motion, in a state where an end tool120bis formed in front of a rotation center121bof the end tool120b, and a manipulation portion110bis formed behind a rotation center111bof the manipulation portion110b, when the manipulation portion110bis rotated in the clockwise direction, the end tool120bmay rotate in the counterclockwise direction, and when the manipulation portion110bis rotated in the counterclockwise direction, the end tool120bmay rotate in the clockwise direction. In this case, from the viewpoint of rotation direction of the manipulation portion110band the end tool120b, a rotation direction in which a user rotates the manipulation portion110bmay be opposite to a resulting rotation direction of the end tool120b. Not only this may result in causing confusion about the manipulation direction to a user, but also movements of joints are not intuitive, which may lead to a mistake. In addition, with reference to (d)FIG.1, in performing a yaw motion, in a state where the end tool120bis formed in front of the rotation center121bof the end tool120b, and the manipulation portion110bis formed behind the rotation center111bof the manipulation portion110b, when the manipulation portion110bis rotated in the clockwise direction, the end tool120bmay rotate in the counterclockwise direction, and when the manipulation portion110bis rotated in the counterclockwise direction, the end tool120bmay rotate in the clockwise direction. In this case, from the viewpoint of rotation direction of the manipulation portion110band the end tool120b, a rotation direction in which a user rotates the manipulation portion110bmay be opposite to a resulting rotation direction of the end tool120b. Not only this may result in causing confusion about the manipulation direction to a user, but also movements of joints are not intuitive, which may lead to a mistake. As such, in the pitch or yaw manipulation by a user of the conventional surgical instruments, there may be a discrepancy between the user manipulation direction and the operation direction of the end tool in terms of rotation direction or left and right direction. This is due to a configuration difference between the end tool and the manipulation portion in the joint configuration of the conventional surgical instruments. That is, the end tool may be formed in front of the rotation center of the end tool, whereas the manipulation portion may be formed behind the rotation center of the manipulation portion. To overcome such issue, in the surgical instrument according to an embodiment of the present disclosure shown in (c) and (f) ofFIG.1, an end tool120cmay be formed in front of a rotation center121cof the end tool120c, and a manipulation portion110cmay also be formed in front of a rotation center111cof the manipulation portion110cso that motions of the manipulation portion110cand the end tool120care intuitively matched. In other words, unlike the existing examples of a configuration in which a manipulation portion approaches a user with respect to its joint (i.e., away from an end tool) as shown in (a), (b), (c), (d) ofFIG.1, in the surgical instrument according to an embodiment shown in (c) and (f) ofFIG.1, at least a part of the manipulation portion may become closer to the end tool than the joint of the manipulation portion in more than one moments during a manipulation process.

In other words, in the case of the conventional surgical instruments shown in (a), (b), (c), and (d) ofFIG.1, as the end tool may be formed in front of its rotation center whereas the manipulation portion may be formed behind its rotation center, the end tool of which front portion moves when its rear portion is fixed may move through a motion of the manipulation portion of which rear portion moves when its front portion is fixed, which is an intuitively unmatching structure. For this reason, a discrepancy in an aspect of left and right direction or an aspect of rotation direction in manipulation of a manipulation portion and motion of an end tool may occur, causing confusion to a user, and the manipulation of the manipulation portion may not be intuitively and quickly performed, which may lead to a mistake. On the contrary, in a surgical instrument according to an embodiment, as both of an end tool and a manipulation portion move based on rotation centers formed behind the end tool and the manipulation portion, respectively, structurally speaking, the motions thereof may intuitively match. In other words, as a moving portion of the end tool moves based on its rotation center formed therebehind, and similarly, a moving portion of the manipulation portion also moves based on its rotation center formed therebehind, structurally, the motions thereof may match intuitively. According to the foregoing, the user may intuitively and quickly control the direction of the end tool, and the possibility of causing a mistake may be significantly reduced. Hereinafter, a detailed mechanism enabling such function will be described.

First Embodiment of a Surgical Instrument for Electrocautery

FIG.2 is a perspective view illustrating a surgical instrument for electrocautery according to a first embodiment of the present disclosure.FIGS.3,4,5, and6 are perspective views illustrating an end tool of the surgical instrument for electrocautery ofFIG.2.FIGS.7 and8 are plan views illustrating the end tool of the surgical instrument for electrocautery ofFIG.2.FIG.9 is a perspective view illustrating an end tool hub of the surgical instrument for electrocautery ofFIG.2.FIGS.10 and11 are cut-away perspective views of the end tool hub ofFIG.9.FIGS.12 and13 are perspective views illustrating the end tool hub ofFIG.9.FIG.14 is a side view illustrating the end tool hub ofFIG.9 and a guide tube.FIG.15 is a plan view illustrating the end tool hub ofFIG.9 and the guide tube.FIGS.16 and17 are plan views illustrating an opening and closing motion of the end tool of the surgical instrument for electrocautery ofFIG.2. First, with reference toFIG.2, the electric cauterization surgical instrument10 according to the first embodiment may include an end tool600, a manipulation portion200, a power transmission portion300, and a connection portion400.

Here, the connection portion400 may be formed in the shape of a hollow shaft, and one or more wires and electric wires may be accommodated therein. As the manipulation portion200 is coupled to one end of the connection portion400, and the end tool600 is coupled to the other end, the connection portion400 may connect the manipulation portion200 to the end tool600. The connection portion400 of the electric cauterization surgical instrument10 according to the first embodiment may include a straight portion401 and a curved portion402. The straight portion401 may be formed at a part of the connection portion400 to which the end tool600 is coupled, and the curved portion402 may be formed at another part of the connection portion400 to which the manipulation portion200 is coupled. As such, as the end of the connection portion400 coupled to the manipulation portion200 is curved, a pitch manipulation portion201, a yaw manipulation portion202, and an actuation manipulation portion203 may be arranged on an extension line of the end tool600 or adjacent to the extension line of the end tool600. In other words, at least a part of the pitch manipulation portion201 and the yaw manipulation portion202 may be accommodated in a concave portion formed by the curved portion402. According to the shape of the curved portion402 described above, the shape and motion of the manipulation portion200 and the end tool600 may match each other more intuitively.

Meanwhile, a plane on which the curved portion402 is formed may be a pitch plane which is substantially the same as the XZ plane ofFIG.2. As such, as the curved portion402 is formed on the plane substantially identical to the XZ plane, interference between the manipulation portions may be reduced. For intuitive operation of the end tool600 and the manipulation portion200, the plane may be configured otherwise in addition to the foregoing (i.e., the XZ plane).

Meanwhile, a connector410 may be formed at the curved portion402. The connector410 may be connected to an external power supply (not illustrated), and the connector410 may be connected to a jaw603 through electric wires411 and412 to transfer electrical energy supplied from the external power supply (not illustrated) to the jaw603. The connector410 may be of a bipolar type having two electrodes, or the connector410 may be of a monopolar type having one electrode.

The manipulation portion200 may be formed at one end of the connection portion400 and may include an interface which can be directly manipulated by a doctor, e.g., an interface in the shape of a pincer, a stick, a lever, etc. When the doctor manipulates the interface, the end tool600, which is connected to the interface and inserted into the body of a patient, may be operated and perform a surgery. Here, althoughFIG.2 illustrates that the manipulation portion200 is formed in the shape of a handle which may be rotated while fingers are inserted, the present disclosure is not limited thereto, and various types of manipulation portions connected to the end tool600 and manipulating the end tool600 may be applicable.

The end tool600 may be formed at the other end of the connection portion400 and may be inserted into a body of a patient to perform operations required for a surgery. As an example of the end tool600, a pair of jaws603 for performing a grip motion may be used as illustrated inFIG.2. However, the technical concepts of the present disclosure are not limited thereto, and various other surgical instruments may be used as the end tool600. For example, a one-armed cautery may be used as the end tool600. As the end tool600 is connected to the manipulation portion200 by the power transmission portion300, the end tool600 may receive driving power of the manipulation portion200 through the power transmission portion300 and perform motions required for a surgery, such as a grip motion, a cutting motion, a suturing motion, etc.

Here, the end tool600 of the electric cauterization surgical instrument10 according to the first embodiment may be formed to be rotatable in at least one direction, and for example, the end tool600 may be formed to perform a yaw movement and an actuation movement around the Z-axis ofFIG.2 simultaneously with performing a pitch movement around the Y-axis ofFIG.2.

Each of the pitch, yaw, and actuation motions used in the present disclosure are defined as follows.

First, the pitch motion may refer to a motion that the end tool600 rotates up and down with respect to a direction in which the connection portion400 extends (i.e., the X-axis direction ofFIG.2), that is, a movement of rotating around the Y-axis ofFIG.2. In other words, the pitch motion may refer to a movement that the end tool600 extending from the connection portion400 in the direction in which the connection portion400 extends (i.e., the X-axis direction inFIG.2) rotates up and down around the Y-axis with respect to the connection portion400.

Next, the yaw motion may refer to a motion that the end tool600 rotates left and right with respect to the direction in which the connection portion400 extends (i.e., the X-axis direction ofFIG.2), that is, a motion of rotating around the Z-axis ofFIG.2. In other words, the yaw motion may refer to a movement that the end tool600 extending from the connection portion400 in the direction in which the connection portion400 extends (i.e., the X-axis direction inFIG.2) rotates left and right around the Z-axis with respect to the connection portion400. That is, the yaw motion means a movement that the two jaws603 formed at the end tool600 rotate around the Z-axis in the same direction.

The actuation motion may refer to a motion that the end tool600 rotates around the same rotation shaft as in the yaw motion or a rotation shaft that is parallel to that in the yaw motion, or and two jaws603 rotate in opposite directions by which the jaws603 are closed together or opened up. That is, the actuation motion may refer to a movement that the two jaws603 formed at the end tool600 rotate in opposite directions around the Z-axis. In an embodiment, the actuation motion may refer to a motion in which, while one of the jaws is stopped, the other jaw rotates with respect to the jaw that is stopped. That is, the actuation motion may refer to a motion in which one jaw rotates with respect to the other jaw.

The power transmission portion300 may transfer the driving power of the manipulation portion200 to the end tool600 by connecting the manipulation portion200 to the end tool600, and may include a plurality of wires, pulleys, links, joints, gears, etc.

The end tool600, the manipulation portion200, the power transmission portion300, etc. of the electric cauterization surgical instrument10 ofFIG.2 will be described in detail later.

(Intuitive Driving)

Hereinafter, the intuitive driving of the electric cauterization surgical instrument10 of the present disclosure is described.

First, a user may hold with his or her palm and rotate a first handle204 around the Y-axis to perform the pitch motion, and may rotate the first handle204 around the Z-axis to perform the yaw motion. In addition, the user may insert his or her thumb and index finger into a first actuation extension portion and/or a second actuation extension portion formed in the shape of a handle at one end of the actuation manipulation portion203 and manipulate the actuation manipulation portion203 to perform the actuation motion.

In the electric cauterization surgical instrument10 according to the first embodiment of the present disclosure, when the manipulation portion200 rotates in one direction with respect to the connection portion400, the end tool600 may rotate in a direction intuitively the same as a manipulation direction of the manipulation portion200. In other words, when the first handle204 of the manipulation portion200 rotates in one direction, the end tool600 may also rotate in a direction intuitively the same as the aforementioned direction to perform a pitch motion or a yaw motion. Here, the intuitively the same direction may indicate that the moving direction of a finger of a user holding the manipulation portion200 is substantially the same as the moving direction of an end portion of the end tool600. The same direction may not be a perfectly matching direction on three-dimensional (3D) coordinates. For example, the sameness of the direction may be understood as a certain degree of sameness, with which, when the finger of the user moves to the left, the end portion of the end tool600 may also move to the left, and when the finger of the user moves downwards, the end portion of the end tool600 may also move downwards.

To this end, in the electric cauterization surgical instrument10 according to the first embodiment, the manipulation portion200 and the end tool600 may be formed in the same direction with respect to a plane perpendicular to the extension axis (the X-axis) of the connection portion400. That is, when seen based on the YZ plane ofFIG.2, the manipulation portion200 may be formed to extend in the +X-axis direction, and at the same time, the end tool600 may also be formed to extend in the +X-axis direction. In other words, the formation direction of the end tool600 at one end of the connection portion400 and the formation direction of the manipulation portion200 at the other end of the connection portion400 may be described as the same direction based on the YZ plane. Alternatively, the manipulation portion200 may be formed in a direction proceeding away from a body of a user holding the manipulation portion200, i.e., a direction towards the end tool600. That is, in the first handle204, the first actuation manipulation portion, and the second actuation manipulation portion, etc., which are held and moved by a user for the actuation motion, the yaw motion, and the pitch motion, the moving portions thereof for the respective motions may extend in the +X axis direction in comparison with the rotation centers of each joint for the respective motions. Based on the foregoing, the moving portion of the end tool600 may extend in the +X axis direction in comparison with the rotation center of each joint for the respective motions, and the manipulation portion200 may also be configured in the same manner. Then, as described above with reference toFIG.1, the user manipulation direction may match the operation direction of the end tool in terms of rotation direction and left and right direction, which leads to intuitively matching manipulation.

More specifically, in the case of a conventional surgical instrument, as a direction in which the user manipulates the manipulation portion and an actual operation direction of the end tool are different and not intuitively the same, an operator may have difficulty in intuitive operation, and may need to use much time to become familiar with directing the end tool in a desired direction. In one embodiment, in some cases, a malfunction may occur, which can cause a damage to a patient.

To overcome such issue, in the electric cauterization surgical instrument10 according to the first embodiment, the manipulation direction of the manipulation portion200 may be intuitively identical to the operation direction of the end tool600, and to this end, a portion of the manipulation portion200 which actually moves for the actuation motion, the yaw motion, and the pitch motion may extend in the +X-axis direction in comparison with a rotation center of a joint for the respective motions as in the end tool600.

Hereinafter, the end tool600, the manipulation portion200, the power transmission portion300, etc. of the electric cauterization surgical instrument10 ofFIG.2 will be described in more detail.

(Power Transmission Portion)

Hereinafter, the power transmission portion300 of the electric cauterization surgical instrument10 ofFIG.2 will be described in more detail. surgical instrument for electrocautery

Referring toFIGS.2 to4,6,7,19,20,26,33,36, and37, the power transmission portion300 of the electric cauterization surgical instrument10 according to an embodiment of the present disclosure may include a wire301, a wire302, a wire303, a wire304, a wire305, a wire306, and a blade wire307.

Here, the wires301 and305 may be paired to serve as first jaw wires. The wires302 and306 may be paired to serve as second jaw wires. Here, the components encompassing the wires301 and305, which are first jaw wires, and the wires302 and306, which are second jaw wires, may be referred to as jaw wires. In addition, the wires303 and304 may be paired to serve as pitch wires.

In addition, the power transmission portion300 of the electric cauterization surgical instrument10 according to an embodiment of the present disclosure may include a fastening member321, a fastening member322, a fastening member323, and a fastening member324 that are coupled to respective end portions of the wires to respectively couple the wires and the pulleys. Here, each of the fastening members may have various shapes as necessary, such as a ball shape, a tube shape, and the like.

Here, at the end tool600 side, the fastening member321/fastening member322 may serve as pitch wire-end tool fastening members, the fastening member323 may serve as a first jaw wire-end tool fastening member, and the fastening member324 may serve as a second jaw wire-end tool fastening member.

In addition, although not shown in the drawings, the manipulation portion200 may further include a fastening member configured to fasten the first jaw wire—the manipulation portion, and a fastening member configured to fasten the second jaw wire—the manipulation portion.

In addition, although not shown in the drawings, a pitch wire-manipulation portion fastening member and a blade wire-manipulation portion fastening member may be further formed at the manipulation portion200 side.

The coupling relationship between the wires, the fastening members, and the respectively pulleys will be described in detail as follows.

First, the wires301 and305, which are first jaw wires, may be a single wire. The fastening member323, which is a first jaw wire-end tool fastening member, is inserted at an intermediate point of the first jaw wire, which is a single wire, and the fastening member323 is crimped and fixed, and then, both strands of the first jaw wire centered on the fastening member323 may be referred to as the wire301 and the wire305, respectively.

Alternatively, the wires301 and305, which are first jaw wires, may also be formed as separate wires and connected by the fastening member323.

In addition, by coupling the fastening member323 to a pulley611, the wires301 and305 may be fixedly coupled to the pulley611. This allows the pulley611 to rotate as the wires301 and305 are pulled and released.

Meanwhile, a first jaw wire-manipulation portion fastening member (not shown in the drawings) may be coupled to the other end portions of the wires301 and305, which are opposite to one end portions to which the fastening member323 is fastened.

As a result, when a pulley of the manipulation portion200 is rotated by a motor or a human force, the pulley611 of the end tool600 may be rotated as the wire301 and the wire305 are pulled and released.

In the same manner, the wire302 and the wire306, which are second jaw wires, are coupled to each of the fastening member324, which is a second jaw wire-end tool fastening member, and a second jaw wire-manipulation portion fastening member (not shown in the drawings).

In addition, the fastening member324 is coupled to a pulley621, and the second jaw wire-manipulation portion fastening member is coupled to a pulley. As a result, when the pulley is rotated by a motor or a human force, the pulley621 of the end tool may be rotated as the wire302 and the wire306 are pulled and released.

In the same manner, the wire304, which is a pitch wire, is coupled to the fastening member321, which is a pitch wire-end tool fastening member, and the pitch wire-manipulation portion fastening member (not shown). In addition, the wire303, which is a pitch wire, is coupled to a fastening member322, which is a pitch wire-end tool fastening member, and the pitch wire-manipulation portion fastening member (not shown).

In addition, the fastening member321 is coupled to a first pitch pulley portion663aof an end tool hub660, the fastening member322 is coupled to a second pitch pulley portion663bof the end tool hub660, and the pitch wire-manipulation portion fastening member (not shown) is coupled to a pulley provided in the manipulation portion200. As a result, when the pulley provided in the manipulation portion200 is rotated by a motor or a human force, the end tool hub660 of the end tool600 may be rotated as the wire303 and the wire304 are pulled and released.

Meanwhile, one end portion of the blade wire307 is coupled to a blade675 to be described later, and the other end portion thereof is coupled to a blade manipulation portion (not shown in the drawings) of the manipulation portion200. By the manipulation of the blade manipulation portion, a cutting motion may be performed as the blade wire307 is moved from a proximal end605 toward a distal end604 of the end tool, or the blade wire307 may return from the distal end604 toward the proximal end605 of the end tool.

At this time, at least a part of the blade wire307 may be accommodated in a guide tube670 to be described later. Accordingly, when the guide tube670 is bent in response to a pitch motion or yaw motion of the end tool600, the blade wire307 accommodated therein may also be bent together with the guide tube670. The guide tube670 will be described in more detail later.

In addition, the blade wire307 is formed in a longitudinal direction of the connection portion400 so as to be linearly movable in the connection portion400. In addition, since one end portion of the blade wire307 is coupled to the blade675, when the blade wire307 is linearly moved in the longitudinal direction of the connection portion400, the blade675 connected thereto is also linearly moved.

That is, when the blade wire307 is linearly moved in the longitudinal direction of the connection portion400, a cutting motion is performed as the blade675 connected thereto is moved toward the distal end604 or the proximal end605 of the end tool600. This will be described in more detail later.

(End Tool)

Hereinafter, the end tool600 of the electric cauterization surgical instrument10 ofFIG.2 will be described in more detail.

FIG.2 is a perspective view illustrating the surgical instrument for electrocautery according to the first embodiment of the present disclosure.FIGS.3,4,5, and6 are perspective views illustrating the end tool of the surgical instrument for electrocautery ofFIG.2.FIGS.7 and8 are plan views illustrating the end tool of the surgical instrument for electrocautery ofFIG.2.FIG.9 is a perspective view illustrating the end tool hub of the surgical instrument for electrocautery ofFIG.2.FIGS.10 and11 are cut-away perspective views of the end tool hub ofFIG.9.FIGS.12 and13 are perspective views illustrating the end tool hub ofFIG.9.FIG.14 is a side view illustrating the end tool hub and the guide tube ofFIG.9.FIG.15 is a plan view illustrating the end tool hub and the guide tube ofFIG.9.FIGS.16 and17 are plan views illustrating an opening and closing motion of the end tool of the surgical instrument for electrocautery ofFIG.2.

Here,FIG.3 illustrates a state in which the end tool hub660 and a pitch hub650 are coupled, andFIG.4 illustrates a state in which the end tool hub660 and pitch hub650 are removed.FIG.5 illustrates a state in which a first jaw601 and a second jaw602 are removed, andFIG.6 illustrates a state in which the first jaw601, the second jaw602, a first electrode651, a second electrode652, and the like are removed. Meanwhile,FIG.7 is a view mainly illustrating the wires, andFIG.8 is a view mainly illustrating the pulleys.

Referring toFIGS.2 to17 and the like, the end tool600 according to the first embodiment of the present disclosure may include a pair of jaws603 for performing a grip motion, that is, the first jaw601 and the second jaw602. Here, each of the first jaw601 and the second jaw602, or a component encompassing the first jaw601 and the second jaw602 may be referred to as the jaw603.

In addition, the end tool may include the pulley611, a pulley613, a pulley614, a pulley615, and a pulley616, which are associated with a rotational motion of the first jaw601. In addition, the end tool may include the pulley621, a pulley623, a pulley624, a pulley625, and a pulley626, which are associated with a rotational motion of the second jaw602.

Here, the pulleys facing each other are illustrated in the drawings as being formed parallel to each other, but the concept of the present disclosure is not limited thereto, and each of the pulleys may be variously formed with a position and a size suitable for the configuration of the end tool.

Further, the end tool600 of the first embodiment of the present disclosure may include the end tool hub660 and the pitch hub650.

Referring toFIG.12, the end tool hub660 may have a first rotation shaft641 to be described later and a second rotation shaft642 of a modified example of the first embodiment to be described later inserted therethrough, and may internally accommodate at least some of the pulley611 and the pulley621 that are axially coupled to the first rotation shaft641. The end tool hub660 will be described in more detail below.

Referring toFIG.3, the pitch hub650 may have a third rotation shaft643 and a fourth rotation shaft644, which will be described later, inserted therethrough, and may be axially coupled to a first pitch pulley portion663aand a second pitch pulley portion663bof the end tool hub660 by the third rotation shaft643. Accordingly, the end tool hub660 may be formed to be rotatable around the third rotation shaft643 with respect to the pitch hub650.

In addition, the pitch hub650 may internally accommodate at least some of the pulley613, the pulley614, the pulley623, and the pulley624 that are axially coupled to the third rotation shaft643. Further, the pitch hub650 may internally accommodate at least some of the pulley615, the pulley616, the pulley625, and the pulley626 that are axially coupled to the fourth rotation shaft644.

One end portion of the pitch hub650 is connected to the end tool hub660, and the other end portion of the pitch hub650 is connected to the connection portion400.

Here, the end tool600 of the first embodiment of the present disclosure may include the first rotation shaft641, the third rotation shaft643, and the fourth rotation shaft644. As described above, the first rotation shaft641 may be inserted through the end tool hub660, and the third rotation shaft643 and the fourth rotation shaft644 may be inserted through the pitch hub650.

Referring toFIG.3, the first rotation shaft641, the third rotation shaft643, and the fourth rotation shaft644 may be arranged sequentially from the distal end604 toward the proximal end605 of the end tool. Accordingly, starting from the distal end604, the first rotation shaft641 may be referred to as a first pin, the third rotation shaft643 may be referred to as a third pin, and the fourth rotation shaft644 may be referred to as a fourth pin.

The second rotation shaft642 of the end tool600 of the electric cauterization surgical instrument10 according to the modified example of the first embodiment, which will be described later, may be inserted through the end tool hub660 and may be referred to as a second pin.

Here, the first rotation shaft641 may function as an end tool jaw pulley rotation shaft, the third rotation shaft643 may function as an end tool pitch rotation shaft, and the fourth rotation shaft644 may function as an end tool pitch auxiliary rotation shaft of the end tool.

Here, each of the rotation shafts may include two shafts of a first sub-shaft and a second sub-shaft. Alternatively, it may be said that each of the rotation shafts is formed by being divided into two parts.

For example, the first rotation shaft641 may include two shafts of a first sub-shaft and a second sub-shaft, which face each other and are disposed to be spaced apart from each other by a certain distance. In addition, the third rotation shaft643 may include two shafts of a first sub-shaft and a second sub-shaft, which face each other and are disposed to be spaced apart from each other by a certain distance. In addition, the fourth rotation shaft644 may include two shafts of a first sub-shaft and a second sub-shaft, which face each other and are disposed to be spaced apart from each other by a certain distance.

Each of the rotation shafts is formed by being divided into two parts as described above to allow the guide tube670 to be described later to pass through the end tool hub660 and the pitch hub650. That is, the guide tube670 may pass between the first sub-shaft and the second sub-shaft of each of the rotation shafts.

This will be described in more detail later. Here, the first sub-shaft and the second sub-shaft may be formed such that longitudinal central axes thereof are disposed on the same axis or may be disposed to be offset to a certain degree.

Meanwhile, it is illustrated in the drawings that each of the rotation shafts is formed by being divided into two parts, but the concept of the present disclosure is not limited thereto. That is, each of the rotation shafts is formed to be curved in the middle such that an escape path for the guide tube670 is formed.

Each of the rotation shafts641,642, and644 may be fitted into one or more pulleys, which will be described in detail below.

Meanwhile, the first rotation shaft641 provided in the end tool600 may be an actuation rotation shaft. In detail, the first rotation shaft641 may be provided in a coupling portion of the first jaw601 and the second jaw602, and may act as a yaw rotation shaft and an actuation rotation shaft.

That is, in the end tool600 of the electric cauterization surgical instrument10 according to the first embodiment of the present disclosure, a yaw rotation shaft and an actuation rotation shaft may be formed of the same rotation shaft, that is, the first rotation shaft641.

In detail, the first rotation shaft641, which is a yaw rotation shaft and an actuation rotation shaft, may be provided in the coupling portion of the first jaw601 and the second jaw602, and the first jaw601 and the second jaw602 may perform an actuation motion while rotating with the first rotation shaft641 as the actuation rotation shaft.

Referring toFIGS.4 to7, the pulley611 functions as an end tool first jaw pulley, and the pulley621 functions as an end tool second jaw pulley. The pulley611 may also be referred to as a first jaw pulley, and the pulley621 may also be referred to as a second jaw pulley, and these two components may collectively be referred to as “end tool jaw pulleys” or simply “jaw pulleys.”

The pulley611 and the pulley621, which are end tool jaw pulleys, are formed to face each other, and are formed to be rotatable independently of each other around the first rotation shaft641, which is an end tool jaw pulley rotation shaft.

In this case, referring toFIG.14, the pulley611 and the pulley621 are formed to be spaced apart from each other by a certain distance, and a blade assembly accommodation portion (no reference number is assigned) may be formed between the pulley611 and the pulley621. In addition, at least a part of the blade assembly (no reference number is assigned) to be described later may be disposed in the blade assembly accommodation portion. In other words, the blade assembly including the guide tube670 may be disposed between the pulley611 and the pulley621.

In addition, a yaw motion and an actuation motion of the end tool are performed in response to the rotation of the pulley611 and the pulley621.

That is, when the pulley611 and the pulley621 rotate in the same direction around the first rotation shaft641, the yaw motion is performed as the first jaw601 and the second jaw602 rotate with the first rotation shaft641 as the central axis of rotation.

Meanwhile, when the pulley611 and the pulley621 rotate in opposite directions around the first rotation shaft641, the actuation motion is performed in a state in which the first jaw601 and the second jaw602 rotate around the first rotation shaft641, of which a central axis of rotation is shared by the yaw rotation shaft and the actuation rotation shaft.

Referring toFIGS.4,6, and8, the pulley613 and the pulley614 function as end tool first jaw pitch main pulleys, and the pulley623 and the pulley624 function as end tool second jaw pitch main pulleys, and these two components may collectively be referred to as end tool jaw pitch main pulleys.

The pulley615 and the pulley616 function as end tool first jaw pitch sub-pulleys, and the pulley625 and the pulley626 function as end tool second jaw pitch sub-pulleys, and these two components may collectively be referred to as end tool jaw pitch sub-pulleys.

Hereinafter, components associated with the rotation of the pulley611 will be described.

The pulley613 and the pulley614 function as end tool first jaw pitch main pulleys. That is, the pulley613 and the pulley614 may function as main rotation pulleys for the pitch motion of the first jaw601. Here, the wire301, which is a first jaw wire, is wound around the pulley613, and the wire305, which is a first jaw wire, is wound around the pulley614.

The pulley615 and the pulley616 function as end tool first jaw pitch sub-pulleys. That is, the pulley615 and the pulley616 function as sub-rotation pulleys for the pitch motion of the first jaw601. Here, the wire301, which is a first jaw wire, is wound around the pulley615, and the wire305, which is a first jaw wire, is wound around the pulley616.

Here, the pulley613 and the pulley614 are disposed on one side of the pulley611 and the pulley612 to face each other. Here, the pulley613 and the pulley614 are formed to be rotatable independently of each other around the third rotation shaft643 that is an end tool pitch rotation shaft.

In addition, the pulley615 and the pulley616 are disposed on one side of the pulley613 and one side of the pulley614, respectively, to face each other. Here, the pulley615 and the pulley616 are formed to be rotatable independently of each other around the fourth rotation shaft644 that is an end tool pitch auxiliary rotation shaft.

Here, in the drawings, it is illustrated that the pulley613, the pulley615, the pulley614, and the pulley616 are all formed to be rotatable around a Y-axis direction, but the concept of the present disclosure is not limited thereto, and the rotation shafts of the respective pulleys may be formed in various directions according to configurations thereof.

Referring toFIG.6, the wire301, which is a first jaw wire, is sequentially wound to make contact with at least portions of the pulley615, the pulley613, and the pulley611. In addition, the wire305 connected to the wire301 by the fastening member323 is sequentially wound to make contact with at least portions of the pulley611, a first wire guide portion668aof the end tool hub680, the pulley614, and the pulley616.

In other words, the wire301 and the wire305, which are the first jaw wire, are sequentially wound to make contact with at least portions of the pulley615, the pulley613, the pulley611, the first wire guide portion668aof the end tool hub680, the pulley614, and the pulley616, and the wire301 and the wire305 formed to move along the above pulleys while rotating the above pulleys.

Accordingly, referring toFIG.7, when the wire301 is pulled in a direction from the distal end604 toward the proximal end605 of the end tool600 (upward direction from a lower side based onFIG.7), the fastening member323, to which the wire301 is coupled, and the pulley611 coupled to the fastening member323 and disposed facing the pulley621 rotate in a first direction (a counterclockwise direction based onFIG.7).

On the contrary, when the wire305 is pulled in the direction from the distal end604 toward the proximal end605 of the end tool600 (upward direction from the lower side based onFIG.7), the fastening member323 to which the wire305 is coupled and the pulley611 coupled to the fastening member323 are rotated in a second direction (a clockwise direction based onFIG.7) opposite to the first direction.

Next, components associated with the rotation of the pulley621 will be described.

The pulley623 and the pulley624 function as end tool second jaw pitch main pulleys. That is, the pulley623 and the pulley624 function as main rotation pulleys for a pitch motion of the second jaw602. Here, the wire306, which is a second jaw wire, is wound around the pulley623, and the wire302, which is a second jaw wire, is wound around the pulley624.

Referring toFIG.7, the pulley625 and the pulley626 function as end tool second jaw pitch sub-pulleys. That is, the pulley625 and the pulley626 function as sub-rotation pulleys for a pitch motion of the second jaw602. Here, the wire306, which is a second jaw wire, is wound around the pulley625, and the wire302, which is a second jaw wire, is wound around the pulley626.

Here, the pulley623 and the pulley624 are disposed on one side of the pulley621 to face each other. Here, the pulley623 and the pulley624 are formed to be rotatable independently of each other around the third rotation shaft643 that is an end tool pitch rotation shaft. In addition, the pulley625 and the pulley626 are disposed on one side of the pulley623 and one side of the pulley624, respectively, to face each other.

Here, the pulley625 and the pulley626 are formed to be rotatable independently of each other around the fourth rotation shaft644 that is an end tool pitch auxiliary rotation shaft. Here, in the drawings, it is illustrated that all of the pulley623, the pulley625, the pulley624, and the pulley626 are formed to be rotatable around the Y-axis direction, but the concept of the present disclosure is not limited thereto, and the rotation shafts of the respective pulleys may be formed in various directions according to configurations thereof.

The wire306, which is a second jaw wire, is sequentially wound to make contact with at least portions of the pulley625, the pulley623, and the pulley621. In addition, the wire302 connected to the wire306 by the fastening member324 is sequentially wound to make contact with at least portions of the pulley621, a second wire guide portion668bof the end tool hub680, the pulley624, and the pulley626.

In other words, the wire306 and the wire302, which are the second jaw wire, are sequentially wound to make contact with at least portions of the pulley625, the pulley623, the pulley621, the second wire guide portion668bof the end tool hub680, the pulley624, and the pulley626, and the wire306 and the wire302 are formed to move along the above pulleys while rotating the above pulleys.

Accordingly, referring toFIG.7, when the wire306 is pulled in the direction from the distal end604 toward the proximal end605 of the end tool600 (upward direction from the lower side based onFIG.7), the fastening member324, to which the wire306 is coupled, and the pulley621 coupled to the fastening member324 and disposed facing the pulley611 are rotated in the first direction (the clockwise direction based onFIG.7).

On the contrary, when the wire302 is pulled in the direction from the distal end604 toward the proximal end605 of the end tool600 (upward direction from the lower side based onFIG.7), the fastening member324 to which the wire302 is coupled and the pulley621 coupled to the fastening member324 are rotated in the second direction (the counterclockwise direction based onFIG.7) opposite to the first direction.

Hereinafter, a pitch motion of the present disclosure will be described in more detail.

Meanwhile, when the wire301 is pulled in the direction of an arrow301 ofFIG.7, and simultaneously, the wire305 is pulled in the direction of an arrow305 ofFIG.7 (that is, when both strands of the first jaw wire are pulled), as shown inFIG.6, since the wires301 and305 are wound around lower portions of the pulley613 and the pulley614 rotatable around the third rotation shaft643, which is an end tool pitch rotation shaft, the pulley611 to which the wires301 and305 are fixedly coupled and the end tool hub660 to which the pulley611 is coupled rotate as a whole in the counterclockwise direction around the third rotation shaft643, and as a result, the end tool may rotate downward to perform the pitch motion.

At this time, since the second jaw602 and the wires302 and306 fixedly coupled thereto are wound around upper portions of the pulley623 and the pulley624 rotatable around the third rotation shaft643, the wires302 and306 are released in the opposite directions of the arrows302 and306, respectively.

On the contrary, when the wire302 is pulled in the direction of an arrow302 ofFIG.7, and simultaneously, the wire306 is pulled in the direction of an arrow306 ofFIG.7, as shown inFIG.6, since the wires302 and306 are wound around the upper portions of the pulley623 and the pulley624 rotatable around the third rotation shaft643, which is an end tool pitch rotation shaft, the pulley621 to which the wires302 and306 are fixedly coupled and the end tool hub660 to which the pulley621 is coupled rotate as a whole in the clockwise direction around the third rotation shaft643, and as a result, the end tool may rotate upward to perform the pitch motion.

At this time, since the first jaw601 and the wires301 and305 fixedly coupled thereto are wound around lower portions of the pulley613 and the pulley614 rotatable around the third rotation shaft643, the wires302 and306 are moved in the opposite directions of the arrows301 and305, respectively.

Meanwhile, the end tool hub660 of the end tool600 of the electric cauterization surgical instrument10 of the present disclosure may further include the first pitch pulley portion663aand the second pitch pulley portion663bserving as end tool pitch pulleys, the manipulation portion200 may further include a manipulation portion pitch pulley (not shown in the drawings), and the power transmission portion300 may further include the wire303 and the wire304 which are pitch wires.

In detail, the end tool hub660 including the first pitch pulley portion663aand the second pitch pulley portion663bmay be formed to be rotatable around the third rotation shaft643 which is an end tool pitch rotation shaft. In addition, the wire303 and the wire304 may serve to connect the first pitch pulley portion663aand the second pitch pulley portion663bof the end tool to the manipulation portion pitch pulley of the manipulation portion200.

Thus, when the manipulation portion pitch pulley of the manipulation portion200 rotates, the rotation of the manipulation portion pitch pulley is transmitted to the end tool hub660 of the end tool600 via the wire303 and the wire304 so that the end tool hub660 rotates together with the manipulation portion pitch pulley, and as a result, the end tool600 performs the pitch motion while rotating.

That is, the electric cauterization surgical instrument10 according to the first embodiment of the present disclosure includes the first pitch pulley portion663aand the second pitch pulley portion663bof the end tool600, the manipulation portion pitch pulley of the manipulation portion200, and the wire303 and the wire304 of the power transmission portion300 in order to transmit driving force for a pitch motion, and thus, the driving force for the pitch motion of the manipulation portion200 is more completely transmitted to the end tool, thereby improving operation reliability.

(Blade Wire and Guide Tube)

Hereinafter, the blade assembly, specifically the blade wire307 and the guide tube670 of the present disclosure, will be described in more detail.

Referring toFIGS.3,4, and6, the guide tube670 according to the present disclosure is formed to surround the blade wire307 in a certain section, and in this case, the blade wire307 is movable inside the guide tube670.

In other words, in a state in which the blade wire307 is inserted into the guide tube670, the blade wire307 may move relative to the guide tube670.

Here, the guide tube670 has a certain degree of rigidity, and serves to guide the path of the blade wire307 by preventing the blade wire307 from being curved in an unintended direction when the blade wire307 is pushed or pulled. A cutting motion on tissue may be smoothly performed by the guide tube670.

Meanwhile, one end portion of the guide tube670 may be fixedly coupled to the end tool hub660 or a preset region (a first coupling portion) of the first jaw601 or the second jaw602, which will be described later. In addition, the other end portion of the guide tube670 may be fixedly coupled to a second coupling portion (not shown) in the connection portion400.

As described above, since both end portions of the guide tube670 are fixedly coupled to certain points (the first coupling portion and the second coupling portion), respectively, the entire length of the guide tube670 may remain constant. Accordingly, the length of the blade wire307 inserted into the guide tube670 may also remain constant.

In addition, the blade wire307 may be prevented from moving in an unintended direction inside the end tool600, which is caused by the blade wire307 being able to move inside the guide tube670.

Meanwhile, the guide tube670 according to the present disclosure may be formed of a flexible material and formed to be bendable. Accordingly, when the end tool performs a yaw motion around the first rotation shaft641 or a pitch motion around the third rotation shaft643, the guide tube670 may be bent while being deformed in shape corresponding thereto. In addition, when the guide tube670 is bent, the blade wire307 thereinside is also bent.

Here, although the length of the guide tube670 is constant, the relative position and distance of the first coupling portion (not shown) and second coupling portion (not shown) may be changed as the end tool600 is pitch-rotated or yaw-rotated, and thus a space for the guide tube670 to move by the changed distance is required.

To this end, a pitch slit664 and a yaw slit665, which are separation spaces, may be provided in the end tool hub660 to form spaces for movement of the guide tube670. Such a configuration of the end tool hub660 will be described in detail later.

Meanwhile, as described above, the blade wire307 is inserted through the guide tube670, and the blade wire307 is relatively movable inside the guide tube670 with respect to the guide tube670. That is, in a state in which the guide tube670 is fixed, when the blade wire307 is pulled in a first direction (in a direction from left to right based onFIG.6), the blade675 connected to the blade wire307 is moved toward the proximal end605, and when the blade wire307 is pushed in a second direction (in a direction from right to left based on inFIG.6), the blade675 connected to the blade wire307 is moved toward the distal end604.

This will be described below in more detail.

The most reliable way to perform a cutting motion using the blade675 is by pushing and pulling the blade675 with the blade wire307. In addition, in order for the blade wire307 to push and pull the blade675, the guide tube670 that can guide the path of the blade wire307 should be provided.

When the guide tube670 does not guide the path of the blade wire307 (i.e., does not hold the blade wire307), a phenomenon may occur in which cutting is not performed and a middle part of the blade wire307 is curved even when the blade wire307 is pushed. Accordingly, in order to reliably perform the cutting motion using the blade675, the blade wire307 and the guide tube670 should be essentially included.

However, when the blade wire307 is used to drive a cutting motion, the cutting should be performed while pushing the blade wire307, and in this case, in order for the blade wire307 to receive a force, a relatively stiff (i.e., non-bendable) wire should be used for the blade wire307. However, the stiff (i.e., non-bendable) wire may have a small bendable range and may be permanently deformed when a force equal to or greater than a certain degree is applied.

In other words, in the case of a stiff (i.e., non-bendable) wire, there is a minimum radius of curvature that may be bent and spread without permanent deformation. In other words, when the wire or the guide tube is curved below a specific radius of curvature, both the wire and the guide tube may undergo permanent deformation while being bent, thereby restricting the capacity to perform cutting while moving backward and forward. Thus, it is necessary to keep the blade wire307 curved while having a gentle curvature.

Accordingly, to prevent the blade wire307 from being rapidly bent while passing through the pulleys, a space is needed in the end tool hub660 to be described below in order to ensure that bending or shape changes in the guide tube670, in which the blade wire307 is accommodated, do not interfere with the end tool hub660.

The blade wire307 and the guide tube670 need to be connected to the blade675 through the end tool hub660, and a space is needed in which the blade wire307 and the guide tube670 are bendable in the end tool hub660, and thus, to this end, in the present disclosure, 1) the pitch slit664 and the yaw slit665 are formed in the end tool hub660, wherein the pitch slit664 and the yaw slit665 correspond to a space in which the blade wire307 and the guide tube670 in which the blade wire307 is accommodated can pass therethrough, and at the same time, are bendable, 2) each of the rotation shafts, specifically, the first rotation shaft641, the third rotation shaft643, and the fourth rotation shaft644 is formed by being divided into two parts that are formed to face each other and to be spaced apart from each other by a certain distance, wherein the first rotation shaft641 is a yaw rotation shaft and also is an actuation rotation shaft, the third rotation shaft643 is a pitch rotation shaft, and the fourth rotation shaft644 is an end tool pitch auxiliary rotation shaft of the end tool600, and 3) a pitch round portion666 and a yaw round portion667 are additionally formed to guide the bending of the blade wire307 and the guide tube670.

In other words, when one end portion of the guide tube670 is fixed in the connection portion400, and the other end portion thereof is moved while performing pitch and yaw motions, the guide tube670 is curved in a direction, in which the gentlest curvature (hereinafter, referred to as “maximum gentle curvature”) can be achieved in response to a change in a distance between both end portions thereof. As such, by achieving the maximum gentle curvature of the natural state, the motion of the blade wire307 is smooth and the permanent deformation does not occur.

Accordingly, in order to secure the maximum gentle curvature, the pitch slit664 and the yaw slit665 are formed on the path of the guide tube670 and, furthermore, the pitch round portion666 and the yaw round portion667, each of which has a curved surface with a certain degree of curvature formed at each surface facing the guide tube670, may be additionally formed in the end tool hub660. Accordingly, the guide tube670 may have such a shape that is the most similar to the maximum gentle curvature (although not having the maximum gentle curvature).

Hereinafter, the end tool hub660 will be described.

(End Tool Hub)

Referring toFIGS.9 to15, the end tool hub660 of the present disclosure may include a body portion661, a first jaw pulley coupling portion662a, a second jaw pulley coupling portion662b, the first pitch pulley portion663a, the second pitch pulley portion663b, the pitch slit664, the yaw slit665, the pitch round portion666, the yaw round portion667, the first wire guide portion668a, and the second wire guide portion668b.

Referring toFIG.9, the first jaw pulley coupling portion662aand the second jaw pulley coupling portion662bmay be formed on the end tool hub at the distal end604 side. The first jaw pulley coupling portion662aand the second jaw pulley coupling portion662bmay be formed to face each other, and may respectively accommodate the end tool first jaw pulley611 and the end tool second jaw pulley612 therein.

Here, the first jaw pulley coupling portion662aand the second jaw pulley coupling portion662bmay be formed to be approximately parallel to a plane perpendicular to the first rotation shaft641 that is a yaw rotation shaft. However, the first jaw pulley coupling portion662aand the second jaw pulley coupling portion662bare not limited thereto, and may be disposed to face each other and formed at a certain angle with the plane perpendicular to the first rotation shaft641, which is a yaw rotation shaft, in any technical concept in which the pulleys611 and612 may be accommodated.

Referring toFIGS.9 and10, the first jaw pulley coupling portion662aand the second jaw pulley coupling portion662bmay be connected by the body portion661. That is, the first jaw pulley coupling portion662aand the second jaw pulley coupling portion662b, which are parallel to each other, are coupled to each other by the body portion661 formed in a direction approximately perpendicular thereto, so that the first jaw pulley coupling portion662a, the second jaw pulley coupling portion662b, and the body portion form an approximately “U” shape, in which each of the end tool first jaw pulley611 and the end tool second jaw pulley612 may be accommodated.

In other words, it may be said that the first jaw pulley coupling portion662aand the second jaw pulley coupling portion662bare formed to extend in the X-axis direction from the body portion661.

Referring toFIGS.9 and12, a through hole (no reference number is assigned) is formed in the first jaw pulley coupling portion662ato allow the first rotation shaft641 to pass through and axially couple the first jaw pulley coupling portion662aand the pulley611, which is an end tool first jaw pulley.

In addition, similar to the first jaw pulley coupling portion662a, a through hole (no reference number is assigned) is formed in the second jaw pulley coupling portion662bto allow the first rotation shaft641 to pass through and axially couple the second jaw pulley coupling portion662band the pulley621, which is an end tool second jaw pulley.

Referring toFIG.12, the first rotation shaft641, which is a yaw rotation shaft, may be formed by being divided into two parts, and the two divided parts of the first rotation shaft641 are connected to the through holes formed in the first jaw pulley coupling portion662aand the second jaw pulley coupling portion662b, respectively, and disposed to be spaced apart from each other by a certain distance.

As a result, a space is formed between the pair of first rotation shafts641 that are connected to the facing first jaw pulley coupling portion662aand second jaw pulley coupling portion662b, respectively, and a space through which the guide tube670 may pass may be formed between the pair of first rotation shafts641.

In other words, by disposing the blade assembly including the guide tube670 and the blade675 between the pulley611, which is a first jaw pulley, and the pulley621, which is a second jaw pulley, the end tool600 is able to perform the cutting motion using the blade675 in addition to the pitch and yaw motions.

Referring toFIGS.9 to11, the first wire guide portion668amay be formed on an inner side surface of the first jaw pulley coupling portion662a, and the second wire guide portion668bmay be formed on an inner side surface of the second jaw pulley coupling portion662b.

The first wire guide portion668aand the second wire guide portion668bmay serve as auxiliary pulleys, and may increase a rotation angle of the end tool600.

The wire guide portions, specifically the first wire guide portion668aand the second wire guide portion668b, are in contact with the wire305 and the wire302, respectively, to change the arrangement path of the wire305 and the wire302 to a certain degree, thereby increasing a rotation radius of each of the first jaw601 and the second jaw602.

That is, when the auxiliary pulleys are not disposed, each of the first jaw pulley611 and the second jaw pulley621 can be yaw-rotated up to a right angle, but by forming the first wire guide portion668aand the second wire guide portion668bformed on the end tool hub660, the effect of increasing the maximum rotation angle of each pulley may be obtained.

This enables a motion in which the two jaws601 and602 of the end tool600 should be spread for an actuation motion while yaw-rotated by 90°.

In other words, the range of yaw rotation in which an actuation motion is possible may be increased through the configuration of the wire guide portions668aand668bof the end tool hub660. In other words, the range of yaw rotation in which an actuation motion is possible may be increased through the configuration of the wire guide portions668aand668bof the end tool hub660.

Furthermore, by forming the wire guide portions668aand668bin the end tool hub660, which already exists, without adding a separate structure such as an auxiliary pulley, the range of rotation may be increased without adding a component and a manufacturing process.

As described above, since there is no need to additionally dispose a separate structure for increasing the rotation angle, the number of components is decreased and the manufacturing process is simplified, and also, the length of the end tool is shortened by as much as the size of the auxiliary pulley, so that the length of the end tool is shortened during a pitch motion. Accordingly, a surgical motion may be more easily performed in a narrow space.

According to the present disclosure as described above, the rotation radii of the pulley611, which is a first jaw pulley, and the pulley621, which is a second jaw pulley, increase, so that a yaw motion range in which a normal opening/closing actuation motion and a normal cutting motion can be performed may be increased.

The first wire guide portion668aand the second wire guide portion668bmay be formed parallel to a plane perpendicular to the first rotation shaft641 that is a yaw rotation shaft. However, the first wire guide portion668aand the second wire guide portion668bare not limited thereto, and may be formed to have a certain angle with a plane perpendicular to the first rotation shaft641, which is a yaw rotation shaft, within the technical concept in which the first wire guide portion668aand the second wire guide portion668bare disposed to face each other.

The yaw slit665 may be formed between the first jaw pulley coupling portion662aand the second jaw pulley coupling portion662b, and between the first wire guide portion668aand the second wire guide portion668b. Since the yaw slit665 is formed in the end tool hub660 as described above, the guide tube670 may pass through the inside of the end tool hub660.

In other words, a pair of divided first rotation shafts641 are vertically separated from each other without passing through the end tool hub660, and the yaw slit665 is formed near the first rotation shaft641 on a plane perpendicular to the first rotation shaft641, thereby allowing the guide tube670 to move in the yaw slit665 while passing near the first rotation shaft641.

Referring toFIGS.9 and10, a yaw round portion667 may be formed on the body portion661. The yaw round portion667 may be formed to be rounded so as to have a certain degree of curvature. Specifically, when viewed from a plane perpendicular to the first rotation shaft641, which is a yaw rotation shaft, the yaw round portion may be formed to have a predetermined curvature. The yaw round portion667 as described above may serve to guide the path of the guide tube670 when the end tool600 yaw-rotates.

For example, the yaw round portion667 may be formed in a fan shape, and may be formed along a path in which the guide tube670 is bent on an XY plane. The yaw round portion667 as described above may serve to guide the path of the guide tube670 when the end tool600 yaw-rotates.

The first pitch pulley portion663aand the second pitch pulley portion663bmay be formed on the end tool hub660 at the proximal end605 side.

In detail, the proximal end605 of the end tool hub660 is formed in a disk shape similar to a pulley, and grooves around which a wire may be wound may be formed on an outer circumferential surface of the proximal end605, thereby forming the first pitch pulley portion663aand the second pitch pulley portion663b.

The wire303 and the wire304 described above are coupled to the first pitch pulley portion663aand the second pitch pulley portion663b, which serve as end tool pitch pulleys, and a pitch motion is performed while the end tool hub660 rotates around the third rotation shaft643.

Meanwhile, although not shown in the drawings, various modifications are possible, e.g., the pitch pulley is formed as a separate member from the end tool hub660 and coupled to the end tool hub660.

The first pitch pulley portion663aand the second pitch pulley portion663bmay be formed to face each other. Here, the first pitch pulley portion663aand the second pitch pulley portion663bmay be formed to be approximately parallel to a plane perpendicular to the third rotation shaft643, which is a pitch rotation shaft.

The first pitch pulley portion663aand the second pitch pulley portion663bmay be connected by the body portion661. That is, the first pitch pulley portion663aand the second pitch pulley portion663b, which are parallel to each other, are coupled by the body portion661 formed in a direction approximately perpendicular to the first pitch pulley portion663aand the second pitch pulley portion663b, and thus the first pitch pulley portion663a, the second pitch pulley portion663b, and the body portion661 may form an approximately U-shape.

In other words, the first pitch pulley portion663aand the second pitch pulley portion663bmay be formed to extend side by side from the body portion661 to face each other in the X-axis direction.

Meanwhile, a through hole (no reference number is assigned) is formed in the first pitch pulley portion663aso that the third rotation shaft643 may pass through and be connected to the first pitch pulley portion663a. A through hole may be formed in the second pitch pulley portion663bas in the first pitch pulley portion663a, and the third rotation shaft643 may pass through the second pitch pulley portion663b.

At this time, the third rotation shaft643, which is a pitch rotation shaft, may be divided into two parts and may be disposed to be spaced apart from each other, and the guide tube670 may move while passing through a space formed between the pair of third rotation shafts643.

Referring toFIG.13, the pitch slit664 may be formed between the first pitch pulley portion663aand the second pitch pulley portion663b. Since the pitch slit664 is formed in the end tool hub660 as described above, the guide tube670 may pass through the inside of the end tool hub660.

Meanwhile, the pitch round portion666 may be further formed in the body portion661. A curved surface may be formed on the pitch round portion666 to have a predetermined curvature. In detail, when viewed from a plane perpendicular to the third rotation shaft643, which is a pitch rotation shaft, the pitch round portion666 may be formed to be rounded to have a predetermined curvature.

For example, the pitch round portion666 may be formed in a fan shape, and may be formed along a path in which the guide tube670 is bent on the XZ plane. The pitch round portion666 as described above may serve to guide the path of the guide tube670 when the end tool600 pitch-rotates.

Accordingly, since the path of the guide tube670 may be guided when the end tool600 pitch-rotates, and the pitch round portion666 having a predetermined curvature and formed to be rounded is formed on the inner side surface of the end tool hub660 that may be in contact with the guide tube670, a sudden path change of the guide tube670 may be prevented, and the guide tube670 and the blade wire307 moving inside the guide tube670 may be stably moved while having a gently curved path.

That is, the pitch round portion666 may serve to guide the path of the guide tube670 when the end tool600 pitch-rotates.

Referring toFIG.9, the pitch slit664 and the yaw slit665 may be formed to be connected to each other. That is, on an outer side with respect to a longitudinal central axis of the guide tube670 located inside the end tool hub660, the pitch slit664 and the yaw slit665 may be alternately formed along a circumferential direction of the end tool hub660.

As a result, the guide tube670 and the blade wire307 located therein may be disposed to pass through the inside of the end tool hub660. In addition, the blade675 located at one end portion of the blade wire307 may linearly reciprocate inside the first jaw601 and the second jaw602.

As described above, since the blade wire307 and the guide tube670 need to be connected to the blade675 through the end tool hub660, and a space is needed in which the blade wire307 and the guide tube670 are able to be bent in the end tool hub660, in the present disclosure, 1) the pitch slit664 and the yaw slit665 are formed in the end tool hub660, wherein the pitch slit664 and the yaw slit665 correspond to a space in which the blade wire307/guide tube670 can pass through the end tool hub660 without interfering the end tool hub660, and at the same time, are bendable, 2) each of the rotation shafts, specifically, the first rotation shaft641 and the third rotation shaft643 is formed by being divided into two parts, and 3) the pitch round portion666 and the yaw round portion667 are additionally formed to guide the bending of the blade wire307 and the guide tube670.

(Components Associated with Cautery and Cutting)

Referring toFIGS.3 to5,18 to20,25,26,31 to33, and35 to37, the end tool600 of the first embodiment of the present disclosure may include the first jaw601, the second jaw602, the first electrode651, the second electrode652, the guide tube670, and the blade675 to perform cauterizing and cutting motions.

Here, components associated with the driving of the blade675, such as the guide tube670 and the blade675, may be collectively referred to as a blade assembly. In an embodiment of the present disclosure, by disposing the blade assembly including the guide tube670 and the blade675 in the yaw slit665 formed between the pulley611, which is a first jaw pulley, and the pulley621, which a second jaw pulley, the end tool600 is able to perform the cutting motion using the blade675 in addition to the pitch and yaw motions. This will be described in more detail.

As described above, the first jaw601 is connected to the first jaw pulley611, and rotates around the first rotation shaft641 integrally with the first jaw pulley611 when the first jaw pulley611 rotates around the first rotation shaft641.

Meanwhile, the first electrode651 may be formed on a surface of the first jaw601 facing the second jaw602. In addition, the second electrode652 may be formed on a surface of the second jaw602 facing the first jaw601.

Referring toFIG.5, a slit651amay be formed in the first electrode651, and the blade675 may move along the slit651a. In addition, a slit652amay be formed in the second electrode652, and the blade675 may move along the slit652ain a preset direction.

In an optional embodiment, a spacer (not shown in the drawings) may be formed between the first jaw601 and the first electrode651, and a spacer may also be formed between the second jaw602 and the second electrode652. The spacer may include an insulating material such as ceramic. Alternatively, the first jaw601 and the second jaw602 may themselves be made of a nonconductor such that the first electrode651 and the second electrode652 may be maintained to be insulated from each other without a separate insulator until the first electrode651 and the second electrode652 are in contact with each other.

Meanwhile, although not shown in the drawings, one or more sensors (not shown) may be further formed on at least one of the first jaw601 or the second jaw602. The sensor (not shown) may be formed to measure at least some of current, voltage, resistance, impedance, and temperature during the cauterization by locating tissue between the first jaw601 and the second jaw602 and passing a current through the first electrode651 and the second electrode652.

Alternatively, instead of providing a separate sensor, monitoring and controlling of at least some of current, voltage, resistance, impedance, and temperature may be directly performed by a generator (not shown) which supplies power to the electrodes.

An edge portion formed sharply and configured to cut tissue may be formed in one region of the blade675. The tissue disposed between the first jaw601 and the second jaw602 may be cut as at least a part of the blade675 moves between the distal end604 and the proximal end605 of the end tool.

Here, the guide tube670 and the blade675 disposed between the pulley611 and the pulley621 are provided in the end tool600 of an electric cauterization surgical instrument10 according to an embodiment of the present disclosure.

In addition, by providing the guide tube670 and the blade675, a multi-joint/multi-degree-of-freedom surgical instrument capable of pitch/yaw/actuation motions may also perform cauterizing and cutting motions. This will be described below in more detail.

So far, various types of surgical instruments for electrocautery have been developed. Among the various types of surgical instruments for electrocautery, a blood vessel resection device called “Advanced Energy Device” or “Vessel Sealer” has a sensing function added to the existing bipolar cautery method, so that power of different polarities may be supplied to two electrodes, and after denaturing a vessel with the heat generated therefrom for hemostasis, the stanched part may be cut with a blade. At this time, the impedance of the tissue (or blood vessel) while the current is flowing is measured to determine whether the cauterization is completed, and when the cauterization is completed, the current supply is automatically stopped, and the tissue is cut with the blade.

In the case of such a bipolar-type blood vessel resection device, it is essential to have a blade to cut the tissue after cauterization, and the end tool needs to be equipped with a mechanism for facilitating a linear motion of the blade, and thus joint movements such as pitch/yaw movements are not possible in most cases.

Meanwhile, there have been attempts to implement joint movements using flexible joints with multiple nodes connected in the bipolar-type blood vessel resection device, but in this case, a rotation angle is limited and it is difficult to achieve accurate motion control of the end tool.

On the other hand, in the case of a method that utilizes vibration of ultrasonic waves to perform hemostasis and cutting, it is not feasible to provide joints due to the physical properties of ultrasonic waves.

To address these problems, the end tool600 of the electric cauterization surgical instrument10 according to an embodiment of the present disclosure includes the guide tube670 disposed between the pulley611 and the pulley621, and the blade675 that moves between a first position and a second position in response to the movement of the blade wire307 disposed inside the guide tube670. In addition, by providing the guide tube670 and the blade675 as described above, pitch/yaw/actuation motions may also be performed using a pulley/wire in a bipolar-type surgical instrument for cauterizing and cutting tissue.

FIG.16 is a view illustrating the end tool600 of the electric cauterization surgical instrument10 ofFIG.2 in an open state, andFIG.17 is a view illustrating the end tool600 in a closed state. In addition,FIG.18 is a view illustrating a state in which the blade wire307 and the blade675 connected to the blade wire307 are located at the first position,FIG.19 is a view illustrating a state in which the blade wire307 and the blade675 are located at the second position, andFIG.20 is a view illustrating a state in which the blade wire307 and the blade675 are located at a third position.

Referring toFIGS.16 to20, it may be said that the tissue between the first jaw601 and the second jaw602 is cut as the cutting motion ofFIGS.18 to20 is performed in a state in which the first jaw601 and the second jaw602 are closed as shown inFIG.16.

Here, the first position illustrated inFIG.18 may be defined as a state in which the blade675 is drawn in toward the proximal end605 of the end tool as much as possible. Alternatively, the first position may also be defined as a state in which the blade675 is located adjacent to the pulley611/pulley612.

Meanwhile, the third position illustrated inFIG.20 may be defined as a state in which the blade675 is withdrawn toward the distal end604 of the end tool600 as much as possible. Alternatively, the third position may also be defined as a state in which the blade675 is spaced away from the pulley611/pulley612 as much as possible.

First, as shown inFIG.17, a tissue to be cut is located between the first jaw601 and the second jaw602 in a state in which the first jaw601 and the second jaw602 are opened, and then an actuation motion is performed to close the first jaw601 and the second jaw602 as shown inFIG.16.

Next, as shown inFIG.18, in a state in which the blade wire307 and the blade675 are located at the first position, currents of different polarities are applied to the first electrode651 and the second electrode652 to cauterize the tissue between the first jaw601 and the second jaw602. At this time, a generator (not shown) configured to supply power to the electrodes may itself perform monitoring of at least some of current, voltage, resistance, impedance, and temperature, and may stop supplying power when the cauterization is completed.

In the state in which the cauterization is completed as described above, when the blade wire307 moves sequentially in the directions of an arrow A1 ofFIG.19 and an arrow A2 ofFIG.20, the blade675 coupled to the blade wire307 moves from the first position at the proximal end605 of the end tool toward the third position at the distal end604 of the end tool, reaching the positions inFIGS.19 and20 in turn.

As such, the blade675 cuts the tissue located between the first jaw601 and the second jaw602 while moving in the X-axis direction.

However, it is to be understood that the linear motion of the blade675 here does not mean a motion in a completely straight line, but rather means a motion of the blade675 to the extent that the blade675 is able to cut the tissue while achieving a linear motion when viewed as a whole, even though the motion is not in a completely straight line, for example, the middle part of the straight line is bent by a certain angle or there is a section having a gentle curvature in a certain section.

Meanwhile, in this state, when the blade wire307 is pulled in the opposite direction, the blade675 coupled to the blade wire307 also returns to the first position.

According to the present disclosure, the multi-joint/multi-degree-of-freedom surgical instrument capable of pitch/yaw/actuation motions may also perform cauterizing and cutting motions.

(Pitch, Yaw, Actuation, and Cutting Motions of End Tool)

FIGS.16 and17 are plan views illustrating an opening and closing motion of the end tool of the surgical instrument for electrocautery ofFIG.2. The first jaw601 may be coupled to the pulley611 and the second jaw602 may be coupled to the pulley621.

The pulley611 functions as an end tool first jaw pulley, and the pulley621 functions as an end tool second jaw pulley. The pulley611 may also be referred to as a first jaw pulley, and the pulley621 may also be referred to as a second jaw pulley, and these two components may collectively be referred to as end tool jaw pulleys or simply jaw pulleys.

The pulley611 and the pulley621, which are end tool jaw pulleys, are formed to face each other, and are formed to be rotatable independently of each other around the first rotation shaft641 which is an end tool jaw pulley rotation shaft. In this case, the pulley611 and the pulley621 are formed to be spaced apart from each other by a certain distance, and the blade assembly, specifically the guide tube670 accommodating the blade wire307 therein may be disposed therebetween.

That is, at least a part of the blade assembly (no reference number is assigned) may be disposed between the pulley611 and the pulley621, and the blade assembly including the guide tube670 may be disposed between the pulley611 and the pulley621.

Referring toFIGS.16 and17, when the pulley621 rotates around the first rotation shaft641, the second jaw602 may also rotate around the first rotation shaft641 together with the pulley621.

Meanwhile, the pulley611 is connected to the first jaw601, and when the pulley611 rotates around the first rotation shaft641, the first jaw601 connected to the pulley611 may rotate around the first rotation shaft641.

In the end tool600 of the electric cauterization surgical instrument10 according to an embodiment of the present disclosure, the first rotation shaft641, which is a yaw rotation shaft, may function as an actuation rotation shaft.

That is, a yaw motion may be performed when the pulley611 and the pulley621, which are connected to the first jaw601 and the second jaw602, respectively, rotate in the same direction with the first rotation shaft641, which is a yaw rotation shaft and an actuation rotation shaft, as the center of rotation, and an actuation motion may be performed when the pulley611 and the pulley621 rotate in different directions.

Referring toFIG.17, as the pulley611 and the pulley621 rotate in opposite directions with the first rotation shaft641 as the central axis of rotation, the first jaw601 and second jaw602, which are connected to the pulley611 and the pulley621, respectively, rotate in opposite directions and move away from each other, and thus the end tool600 may be in an open state.

Referring toFIGS.21 and22, bottom views are illustrated in which a process of performing an opening and closing motion in a state in which the end tool600 of the electric cauterization surgical instrument10 ofFIG.2 is yaw-rotated by −90°.

InFIG.21, the pulley611 and the pulley621 that faces the pulley611 may rotate around the first rotation shaft641 through the power transmission portion300 in the manipulation portion200. InFIG.21, when the pulley611 and the pulley621 rotate in opposite directions, the first jaw601 and the second jaw602 respectively coupled to the pulley611 and the pulley621 may rotate relative to each other in a direction of approaching each other to perform an actuation motion, and as shown inFIG.22, the first jaw601 and the second jaw602 may be in a closed state.

FIGS.23 and24 are bottom views illustrating a process of performing an opening and closing motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.2 is yaw-rotated by +90°. Referring toFIGS.23 and24, as the pulley611 and the pulley611 are yaw rotatable by +90° with the first rotation shaft641 as the central axis of rotation, and the pulley611 and the pulley611 rotates in different directions, an actuation motion is possible in which the first jaw601 and the second jaw602 respectively connected to the pulley611 and the pulley621 move closer or further away from each other.

Referring toFIGS.21 to24, the blade assembly, specifically, the guide tube670 is connected to the end tool600 at the other end portion, which is opposite one end portion connected to the connection portion400, and may be of constant length.

The guide tube670 may be gently curved with a predetermined radius of curvature when the end tool600, specifically, the first jaw601 and the second jaw602 rotate with the first rotation shaft641 as the central axis of rotation, and may stably provide a movement path for the blade wire307 to be movable between the distal end604 and the proximal end605 of the end tool600.

FIGS.25 and26 are views illustrating a path of the guide tube670 and a movement path of the blade675 during a cutting motion in a state in which the end tool600 of the surgical instrument for electrocautery ofFIG.2 is yaw-rotated by +90°.

Referring toFIGS.25 and26, the end tool600 of the electric cauterization surgical instrument10 according to the first embodiment of the present disclosure is formed such that the jaws601 and602 are able to perform a normal cutting motion even when the jaws are yaw-rotated by +90°.

Specifically, as the blade wire307 emerges from the inside of the guide tube670, and the blade675 connected to the blade wire307 moves in the direction of an arrow A, which is a direction from the proximal end605 toward the distal end604 of the end tool600, a cutting motion may be performed.

FIGS.27 and28 are views illustrating a process of performing an opening and closing motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.2 is pitch-rotated by −90°.FIGS.29 and30 are views illustrating a process of performing an opening and closing motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.2 is pitch-rotated by +90°.FIG.31 is a view illustrating a path of the guide tube in a state in which the end tool of the surgical instrument for electrocautery of FIG.2 is pitch-rotated by −90°.FIGS.32 and33 are views illustrating a path of the guide tube and a movement path of the blade during a cutting motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.2 is pitch-rotated by −90°.

Referring toFIGS.27 to33, the end tool600 of the electric cauterization surgical instrument10 according to the first embodiment of the present disclosure is formed such that the jaws601 and602 are able to perform a cutting motion normally even when the jaws are pitch-rotated by −90° and +90°.

Meanwhile,FIG.34 is a view illustrating a state in which the jaws are pitch-rotated by −90° and simultaneously yaw-rotated by +90°, andFIGS.35 to37 are views illustrating the end tool of the surgical instrument for electrocautery ofFIG.2 performing a cutting motion in a state in which the end tool is pitch-rotated by −90° and simultaneously yaw-rotated by +90°.

Referring toFIGS.34 to37, the end tool600 of the electric cauterization surgical instrument10 according to the first embodiment of the present disclosure is formed such that the jaws601 and602 are able to perform a cutting motion normally even when the jaws are pitch-rotated by −90° and simultaneously yaw-rotated by +90°.

Modified Example of First Embodiment-Disposing Auxiliary Pulley on End Tool Hub

Hereinafter, an end tool600 of a surgical instrument according to a modified example of the first embodiment of the present disclosure will be described. Here, the end tool600 of the surgical instrument according to the modified example of the first embodiment of the present disclosure is different from the end tool of the surgical instrument according to the first embodiment of the present disclosure described above in that the configuration of an end tool hub660′ and the configuration of auxiliary pulleys612 and622 are different. The configuration changed from the first embodiment as described above will be described in detail later.

FIGS.38 to40 are views illustrating the end tool of the surgical instrument for electrocautery according to the modified example of the first embodiment of the present disclosure.

Referring toFIGS.38 to40, the end tool600 of the modified example of the first embodiment of the present disclosure includes a pair of jaws for performing a grip motion, specifically a first jaw601 and a second jaw602, and here, each of the first jaw601 and the second jaw602 or a component encompassing the first jaw601 and the second jaw602 may be referred to as a jaw603.

The end tool600 according to the modified example of the first embodiment may include a pulley611, the pulley612, a pulley613, a pulley614, a pulley615, and a pullcy616 that are associated with a rotational motion of the first jaw601. In addition, the end tool600 may include a pulley621, the pulley622, a pulley623, a pulley624, a pulley625, and a pulley626 that are associated with a rotational motion of the second jaw602.

Here, the pulleys facing each other are illustrated in the drawings as being formed parallel to each other, but the concept of the present disclosure is not limited thereto, and each of the pulleys may be variously formed with a position and a size suitable for the configuration of the end tool.

The end tool600 according to the modified example of the first embodiment of the present disclosure may further include the pulley612 and the pulley622 as compared to the end tool600 according to the first embodiment of the present disclosure illustrated with reference toFIG.6.

Referring toFIGS.39 and40, the pulley612 functions as an end tool first jaw auxiliary pulley, and the pulley622 functions as an end tool second jaw auxiliary pulley, and these two components may collectively be referred to as end tool jaw auxiliary pulleys or simply auxiliary pulleys.

In detail, the pulley612 and the pulley622, which are end tool jaw auxiliary pulleys, may be additionally provided on one side of the pulley611 and one side of the pulley621, respectively. In other words, the pulley612, which is an auxiliary pulley, may be disposed between the pulley611 and the pulley613/pulley614. In addition, the pulley622, which is an auxiliary pulley, may be disposed between the pulley621 and the pulley623/pulley624.

The pulley612 and the pulley622 may be formed to be rotatable independently of each other around the second rotation shaft642.

The pulley612 and the pulley622 may serve to increase rotation angles of the first jaw601 and the second jaw602, respectively, by coming into contact with the wire305, which is a first jaw wire, and the wire302, which is a second jaw wire, and changing the arrangement paths of the wire305 and the wire302 to a certain degree.

That is, when the auxiliary pulleys are not disposed, each of the first jaw601 and the second jaw602 may rotate only up to a right angle, but in the modified example of the first embodiment, by additionally providing the pulley612 and the pulley622, which are auxiliary pulleys, the effect of increasing the maximum rotation angle by a certain angle can be achieved.

This enables a motion in which two jaws of the end tool600 have to be spread apart for an actuation motion in a state in which the two jaws are yaw-rotated together by 90° in the clockwise or counterclockwise direction.

In other words, a feature of increasing the range of yaw rotation in which an actuation motion is possible may be obtained through the pulley612 and the pulley622. This will be described below in more detail.

When the auxiliary pulleys are not disposed, since the first jaw wire305 is fixedly coupled to the end tool first jaw pulley611, and the second jaw wire302 is fixedly coupled to the end tool second jaw pulley621, each of the end tool first jaw pulley611 and the end tool second jaw pulley621 may rotate up to 90°.

In this case, when the actuation motion is performed in a state in which the first jaw601 and the second jaw602 are located at a 90° line, the first jaw601 may be spread, but the second jaw602 may not be rotated beyond 90°. Accordingly, when the first jaw601 and the second jaw602 perform a yaw motion over a certain angle, there was a problem that an actuation motion is not smoothly performed.

In order to address such a problem, in the electric cauterization surgical instrument10 of the present disclosure, the pulley612 and the pulley622, which are auxiliary pulleys, are additionally disposed at one side of the pulley611 and one side of the pulley621, respectively. As described above, as the arrangement paths of the wire305, which is a first jaw wire, and the wire302, which is a second jaw wire, are changed to a certain degree by disposing the pulley612 and the pulley622, a tangential direction of the wires305 and302 is changed, and accordingly, a fastening member324 for coupling the wire302 and the pulley621 is additionally rotatable by a certain angle.

That is, a fastening member326, which is a coupling portion of the wire302 and the pulley621, is rotatable until being located on a common internal tangent of the pulley621 and the pulley622. Similarly, a fastening member323, which is a coupling portion of the wire305 and the pulley611, is rotatable until being located on a common internal tangent of the pulley611 and the pulley612, so that the range of rotation may be increased.

In other words, due to the pulley612 that is an auxiliary pulley, the wires301 and305, which are two strands of the first jaw wire wound around the pulley612, are disposed at one side with respect to a plane perpendicular to the Y-axis and passing through the X-axis. Simultaneously, due to the pulley622, the wires302 and306, which are two strands of the second jaw wire wound around the pulley621, are disposed at the other side with respect to the plane perpendicular to the Y-axis and passing through the X-axis.

In other words, the pulley613 and the pulley614 are disposed at one side with respect to the plane perpendicular to the Y-axis and passing through the X-axis, and the pulley623 and the pulley624 are disposed at the other side with respect to the plane perpendicular to the Y-axis and passing through the X-axis.

In other words, the wire305 is located on the internal tangent of the pulley611 and the pulley612, and the rotation angle of the pulley611 is increased due to the pulley612. In addition, the wire302 is located on the internal tangent of the pulley621 and the pulley622, and the rotation angle of the pulley621 is increased due to the pulley622.

According to the present disclosure, the rotation radii of the first jaw601 and the second jaw602 increase, so that an effect of increasing a yaw motion range in which a normal opening/closing actuation motion can be performed may be obtained.

Referring toFIG.38, a first rotation shaft641 and a second rotation shaft642 may be inserted through the end tool hub660′ according to the modified example of the first embodiment of the present disclosure. Instead of respectively forming the first wire guide portion and the second wire guide portion on the surfaces of the first jaw pulley coupling portion662aand the second jaw pulley coupling portion662bfacing each other as in the end tool hub660 according to the first embodiment of the present disclosure, the pulley612 and the pulley622, which are configured as separate components from the end tool hub660′ and are able to be axially coupled to the second rotation shaft642 that is inserted through the end tool hub660′, are additionally provided and allowed to function as auxiliary pulleys.

The second rotation shaft642 inserted through the end tool hub660′ may include two shafts including a first sub-shaft and a second sub-shaft that face each other and are disposed to be spaced apart from each other by a certain distance. The second rotation shaft is divided into two parts and spaced apart from each other by a certain distance, and thus the guide tube670 may pass through the end tool hub660′ and the pitch hub650 through between the two parts.

Referring toFIG.38, the first rotation shaft641, the second rotation shaft642, a third rotation shaft643, and a fourth rotation shaft644 may be arranged sequentially from a distal end604 toward a proximal end605 of the end tool600. Accordingly, starting from the distal end604, the first rotation shaft641 may be referred to as a first pin, the second rotation shaft642 may be referred to as a second pin, the third rotation shaft643 may be referred to as a third pin, and the fourth rotation shaft644 may be referred to as a fourth pin.

As compared to the first embodiment, the end tool600 of the modified example of the first embodiment of the present disclosure has the same configuration as the end tool600 according to the first embodiment, except that the pulley621 and the pulley622, which are axially coupled to the end tool hub660′ by the second rotation shaft642, are provided as separate components instead of being integrally formed with a body portion661 in the end tool hub660′ and function as auxiliary pulleys, and thus a detailed description thereof will be omitted in the overlapping range.

Second Embodiment of Surgical Instrument for Electrocautery-Forming X-Shaped Structure of First and Second Jaws

FIG.41 is a perspective view illustrating a surgical instrument for electrocautery according to a second embodiment of the present disclosure.FIGS.42 to47 are views illustrating an end tool of the surgical instrument for electrocautery ofFIG.41.

Referring toFIG.41, an electric cauterization surgical instrument10 according to the second embodiment of the present disclosure includes an end tool700, a manipulation portion200, a power transmission portion300, and a connection portion400.

The electric cauterization surgical instrument10 according to the second embodiment of the present disclosure is different from the electric cauterization surgical instrument10 according to the first embodiment in that the end tool700 has a different configuration, and thus the configuration of the end tool700 will be described in detail below.

The end tool700 is formed on the other end portion of the connection portion400, and performs necessary motions for surgery by being inserted into a surgical site. In an example of the end tool700 described above, as illustrated inFIG.41, a pair of jaws703 for performing a grip motion may be used.

However, the concept of the present disclosure is not limited thereto, and various devices for performing surgery may be used as the end tool700. For example, a configuration of a cantilever cautery may also be used as the end tool700. The end tool700 is connected to the manipulation portion200 by the power transmission portion300, and receives a driving force of the manipulation portion200 through the power transmission portion300 to perform a motion necessary for surgery, such as gripping, cutting, suturing, or the like.

Here, the end tool700 of the electric cauterization surgical instrument10 according to the second embodiment of the present disclosure is formed to be rotatable in at least one direction, and for example, the end tool700 may be formed to perform a pitch motion around a Y-axis ofFIG.41 and simultaneously perform a yaw motion and an actuation motion around a Z-axis ofFIG.41.

Referring toFIGS.42 to47,55, and56, the end tool700 of the electric cauterization surgical instrument10 according to the second embodiment of the present disclosure includes a first electrode751, a second electrode752, a pitch hub750, an end tool hub760, a plurality of rotation shafts741,743, and744, and the like that are the same as those of the first embodiment in configuration and effect, and is different in that a jaw rotation shaft701c, a tube through hole701f, a jaw pulley coupling hole701d, and a movable coupling hole701care formed in a first jaw701, and a shaft pass-through portion702ethrough which the rotation shaft701c, which is a jaw rotation shaft formed in the first jaw701, is able to pass, a movable coupling hole702c, and a hole702d, which is a jaw pulley coupling hole, are formed in a second jaw702 that faces and is connectable to the first jaw701.

FIG.48 is a perspective view illustrating the end tool hub of the surgical instrument for electrocautery ofFIG.41.FIGS.49 and50 are cut-away perspective views of the end tool hub ofFIG.48.FIGS.51 and52 are perspective views illustrating the end tool hub ofFIG.48.FIG.53 is a side view illustrating the end tool hub ofFIG.48 and a guide tube.FIG.54 is a plan view illustrating the end tool hub ofFIG.48 and the guide tube.

Referring toFIGS.48 to54, the end tool hub760 provided in the end tool700 of the electric cauterization surgical instrument10 ofFIG.41 has a predetermined radius of curvature on an inner circumferential surface thereof for gentle curved movement of the guide tube670, and may include a yaw round portion767 and a pitch round portion766 formed in a curved shape.

In addition, a yaw slit765 passing through the end tool hub760 may be formed on a plane perpendicular to a first rotation shaft741 to allow a guide tube770, which is configured to guide a movement path of a blade775 and the blade wire307 connected to the blade775, to stably move through the end tool hub760.

In addition, a pitch slit764, which is a separation space, may be formed between a first pitch pulley portion763aand a second pitch pulley portion763bfacing each other so that the guide tube670 may pass therethrough, thereby allowing the guide tube770 to stably move through the pitch slit764.

Referring toFIG.51, in addition to the yaw slit765 formed in the end tool hub760, the yaw rotation shaft741 may be divided into two parts and provided as a pair, and the guide tube670 may move through a space formed between the divided pair of yaw rotation shafts741.

Referring toFIGS.51 to54, the end tool hub760 of the surgical instrument for electrocautery according to the second embodiment has the same configuration as the end tool hub660 of the surgical instrument for electrocautery according to the first embodiment, and thus a detailed description thereof will be omitted in the overlapping range.

FIG.55 is a perspective view illustrating the first jaw of the end tool of the surgical instrument for electrocautery ofFIG.41.FIG.56 is a perspective view illustrating the second jaw of the end tool of the surgical instrument for electrocautery ofFIG.41.

Referring toFIG.55, the first jaw701 of the end tool700 of the surgical instrument for electrocautery ofFIG.41 may include the jaw rotation shaft701e, which has the tube through hole701fformed therein and is formed to protrude, the movable coupling hole701c, and the jaw pulley coupling hole701d.

The first jaw701 is formed entirely in an elongated bar shape, a path through which the blade775 is movable is formed in the first jaw701 at a distal end side (left side based onFIG.55), and a pulley711, which is a first jaw pulley, is coupled to the first jaw701 at a proximal end side (right side based onFIG.55) and formed to be rotatable around the rotation shaft741.

Referring toFIG.55, the movable coupling hole701cand the jaw pulley coupling hole701dmay be formed in the first jaw701 at the proximal end side. Here, the movable coupling hole701cmay be formed to have a predetermined curvature, and may be formed in an approximately elliptical shape.

A shaft coupling portion711aformed on the first jaw pulley711 may be fitted into the movable coupling hole701cformed in the first jaw701. Here, a short radius of the movable coupling hole701cmay be formed to be substantially the same as or slightly greater than a radius of the shaft coupling portion711a.

Referring toFIG.55, a long radius of the movable coupling hole701cmay be formed to be greater than the radius of the shaft coupling portion711a. Thus, a path may be formed so that the shaft coupling portion711ais movable therethrough to a certain degree in the movable coupling hole701cin a state in which the shaft coupling portion71 la of the pulley711 is fitted into the movable coupling hole701cof the first jaw701, This will be described in detail later.

Referring toFIG.55, the jaw pulley coupling hole701dformed in the first jaw701 is formed in the form of a cylindrical hole, and a jaw coupling portion711bof the pulley711 may be fitted into the jaw pulley coupling hole701d.

Here, a radius of the jaw pulley coupling hole101dmay be formed to be substantially the same as or relatively greater than a radius of the jaw coupling portion711b. Thus, the jaw coupling portion711bof the pulley711 may be formed to be rotatably coupled to the jaw pulley coupling hole701dof the first jaw701. This will be described in more detail later.

Referring toFIG.56, the second jaw702 disposed to face the first jaw701 may include the shaft pass-through portion702e, the movable coupling hole702c, and the jaw pulley coupling hole702d. The second jaw702 may be formed entirely in an elongated bar shape, the shaft pass-through portion702emay be formed in the distal end, and the jaw pulley coupling hole702dmay be formed in the proximal end.

Referring toFIG.59, the movable coupling hole702cformed in the second jaw702 may be formed to have a predetermined curvature and may be formed in an approximately elliptical shape. A shaft coupling portion721aof a pulley721 may be fitted into the movable coupling hole702c. Here, a short radius of the movable coupling hole702cmay be formed to be substantially the same as or slightly greater than a radius of the shaft coupling portion721a.

Meanwhile, a long radius of the movable coupling hole702cmay be formed to be relatively greater than the radius of the shaft coupling portion721a. Thus, the shaft coupling portion721ais formed to be movable to a certain degree in the movable coupling hole702cin a state in which the shaft coupling portion721aof the pulley721 is fitted into the movable coupling hole702cof the second jaw702. This will be described in more detail later.

Meanwhile, the jaw pulley coupling hole702dis formed in the form of a cylindrical hole, and a jaw coupling portion721bof the pulley721 may be fitted into the jaw pulley coupling hole702d. Here, a radius of the jaw pulley coupling hole702dmay be formed to be substantially the same as or greater than a radius of the jaw coupling portion721b. Thus, the jaw coupling portion721bof the pulley721 may be rotatably coupled to the jaw pulley coupling hole702dof the second jaw702.

Meanwhile, the shaft pass-through portion702emay be formed in the second jaw702 at the distal end side relative to the movable coupling hole702cand the jaw pulley coupling hole702d.

Referring toFIGS.55 and56, the shaft pass-through portion702eformed in the second jaw702 may be formed in a hole shape, and the jaw rotation shaft701eformed in the first jaw701 may be inserted through the shaft pass-through portion702c.

Referring toFIG.57, the pulley711, which is a first jaw pulley, may include the shaft coupling portion71 la and the jaw coupling portion711b. The pulley711 is formed entirely in the shape of a rotatable disk and has one surface (lower surface based onFIG.57) on which the shaft coupling portion711aand the jaw coupling portion711bmay be formed to protrude to a certain degree.

As described above, the shaft coupling portion711aof the pulley711 may be fitted into the movable coupling hole701cof the first jaw701, and the jaw coupling portion711bof the pulley711 may be fitted into the jaw pulley coupling hole701dof the first jaw701. The pulley711 may be formed to be rotatable with the rotation shaft741, which is an end tool jaw pulley rotation shaft, as the center of rotation.

Meanwhile, the pulley721, which is a second jaw pulley, may include the shaft coupling portion721aand the jaw coupling portion721b.

The second jaw pulley721 is formed entirely in the form of a rotatable disk and has one surface on which the shaft coupling portion721aand the jaw coupling portion721bmay be formed to protrude to a certain degree. As described above, the shaft coupling portion712aof the pulley712 may be fitted into the movable coupling hole702cof the second jaw702, and the jaw coupling portion712bof the pulley712 may be fitted into the jaw pulley coupling hole702dof the second jaw702. The pulley721 may be formed to be rotatable with the rotation shaft741, which is an end tool jaw pulley rotation shaft, as the center of rotation.

The coupling relationship between the components described above is as follows.

The rotation shaft741, which is an end tool jaw pulley rotation shaft, is sequentially inserted through the shaft coupling portion711aof the pulley711, the movable coupling hole701cof the first jaw701, the movable coupling hole702cof the second jaw702, and the shaft coupling portion721aof the pulley721.

The rotation shaft701e, which is a jaw rotation shaft, is inserted through the shaft pass-through portion702eof the second jaw702.

The shaft coupling portion711aof the pulley711 is fitted into the movable coupling hole701cof the first jaw701, and the jaw coupling portion711bof the pulley711 is fitted into the jaw pulley coupling hole701dof the first jaw701.

At this time, the jaw pulley coupling hole701dof the first jaw701 and the jaw coupling portion711bof the pulley711 are axially coupled to each other so as to be rotatable, and the movable coupling hole701cof the first jaw701 and the shaft coupling portion711aof the pulley711 are movably coupled to each other.

The shaft coupling portion721aof the pulley721 is fitted into the movable coupling hole702cof the second jaw702, and the jaw coupling portion721bof the pulley721 is fitted into the jaw pulley coupling hole702dof the second jaw702.

At this time, the jaw pulley coupling hole702dof the second jaw702 and the jaw coupling portion721bof the pulley721 are axially coupled to each other to be rotatable, and the movable coupling hole702cof the second jaw702 and the shaft coupling portion721aof the pulley721 are movably coupled to each other.

Here, the pulley711 and the pulley721 rotate around the rotation shaft741, which is an end tool jaw pulley rotation shaft. The first jaw701 and the second jaw702 rotate around the rotation shaft701e, which is a jaw rotation shaft. That is, the pulley711 and the first jaw701 have different shafts of rotation. Similarly, the pulley721 and the second jaw702 have different shafts of rotation.

That is, the rotation angle of the first jaw701 is limited to a certain degree by the movable coupling hole701c, but is essentially rotated about the rotation shaft701e, which is a jaw rotation shaft. Similarly, the rotation angle of the second jaw702 is limited to a certain degree by the movable coupling hole702c, but is essentially rotated around the rotation shaft701e, which is a jaw rotation shaft.

Amplification of grip force due to the coupling relationship between the above-described components will be described.

FIG.58 is a plan view illustrating an opening and closing motion of the first jaw of the end tool of the surgical instrument for electrocautery ofFIG.41.FIG.59 is a plan view illustrating an opening and closing motion of the second jaw of the end tool of the surgical instrument for electrocautery ofFIG.41.FIG.60 is a plan view illustrating an opening and closing motion of the first jaw and the second jaw of the end tool of the surgical instrument for electrocautery ofFIG.41.

Referring toFIGS.58 to60, in the electric cauterization surgical instrument10 according to the second embodiment, the coupling structure of the first jaw701 and the second jaw702 forms an X-shaped structure, so that when the first jaw701 and the second jaw702 rotate in a direction of approaching each other (i.e. when the first jaw701 and the second jaw702 are closed), a grip force in a direction of closing the first jaw701 and the second jaw702 further increases. This will be described below in more detail.

As described above, in motions of the first jaw701 and the second jaw702 being opened and closed, there are two shafts that serve as the centers of rotation for the first jaw701 and the second jaw702.

That is, the first jaw701 and the second jaw702 perform an opening and closing motion around two shafts of the rotation shaft741 and the rotation shaft701e. In this case, the centers of rotation of the first jaw701 and the second jaw702 become the rotation shaft701e, and the centers of rotation of rotation of the pulley711 and the pulley721 become the rotation shaft741.

At this time, the rotation shaft741 is a shaft whose position is relatively fixed, and the rotation shaft701eis a shaft whose position is relatively moved linearly. In other words, when the pulley711 and the pulley721 rotate in a state in which the position of the rotation shaft741 is fixed, the first jaw701 and the second jaw702 are opened/closed while the rotation shaft701e, which is a rotation shaft of the first jaw701 and the second jaw702, is moved backward and forward. This will be described below in more detail.

InFIG.58, r1 is a distance from the jaw coupling portion711bof the pulley711 to the shaft coupling portion711a, and a length thereof is constant. Thus, a distance from the rotation shaft741 inserted into the shaft coupling portion711ato the jaw coupling portion711bis also constant as r1.

Meanwhile, r2 ofFIG.58 is a distance from the jaw pulley coupling hole701dof the first jaw701 to the rotation shaft701ethat is a jaw rotation shaft, and a length thereof is constant. Thus, a distance from the jaw coupling portion711bof the pulley711 inserted into the jaw pulley coupling hole701dto the jaw rotation shaft701eis also constant as r2.

Referring toFIG.58, the lengths of r1 and r2 remain constant. Accordingly, when the pulley711 and the pulley721 rotate in the directions of an arrow A1 ofFIG.58 and of an arrow A2 ofFIG.59, respectively, around the rotation shaft741 to perform a closing motion, the first jaw701 and the second jaw702 rotate around the rotation shaft701eas the angle between r1 and r2 changes while the lengths of r1 and r2 remain constant, and at this time, the rotation shaft701eitself is also linearly moved (i.e., is moved forward/backward) by as much as an arrow C1 ofFIG.58 and an arrow C2 ofFIG.59.

That is, assuming that the position of the rotation shaft741, which is an end tool jaw pulley rotation shaft, is fixed, when the first jaw701 and the second jaw702 are closed, a force is applied in a direction in which the rotation shaft701e, which is a jaw rotation shaft, is moved forward (i.e., toward the distal end), and thus the grip force in the direction in which the first jaw701 and the second jaw702 are closed becomes larger.

In other words, since the lengths of r1 and r2 remain constant when the second jaw702 rotates around the jaw rotation shaft701e, when the pulley721 rotates around the rotation shaft741, the angle between r1 and r2 changes while the lengths of r1 and r2 remain constant. That is, the angle between r1 and r2 in a state in which the second jaw702 is open as shown inFIG.59A is relatively greater than the angle between r1 and r2 in a state in which the second jaw702 is closed as shown inFIG.59B.

Thus, when the second jaw702 rotates from the open state to the close state, the angle between r1 and r2 changes, and a force is applied in a direction in which the jaw rotation shaft701epassing through the shaft pass-through portion702eformed in the second jaw702 is moved forward.

In this case, since the rotation shaft741 is a shaft whose position is relatively fixed, the jaw rotation shaft701eis moved forward in the direction of the arrow C1 ofFIG.58 and the direction of an arrow C2 ofFIG.59, and the grip force is further increased in a direction in which the second jaw702 is closed.

In other words, when the pulley711 and the pulley721 rotate around the rotation shaft741, which is a shaft whose relative position is fixed, the angle between r1 and r2 changes while the distance between r1 and r2 remains constant. In addition, when the angle changes as described above, the first jaw701 and the second jaw702 push or pull the rotation shaft701e, and thus the jaw rotation shaft701eis moved forward or backward.

In this case, when the first jaw701 and the second jaw702 rotate in the direction of closing, the grip force is further increased as the rotation shaft701eis moved forward in the directions of the arrow C1 ofFIG.58 and the arrow C2 ofFIG.59.

On the contrary, when the first jaw701 and the second jaw702 rotate in the direction of opening, the rotation shaft701eis moved backward in directions opposite to the arrow C1 ofFIG.58 and the arrow C2 ofFIG.59.

With this configuration, the grip force becomes stronger when the first jaw701 and the second jaw702 are closed, thereby enabling a surgical operator to perform the actuation motion powerfully even with a small force.

That is, as shown inFIG.60, as the first jaw701 and the second jaw702, which have an X-shaped structure, rotate relative to each other around the first rotation shaft741 that is a fixed shaft, the rotation shaft701e, which is a jaw rotation shaft, is moved forward toward the distal end of the end tool700, so that the grip force may be amplified.

FIGS.61 and62 are plan views illustrating an opening and closing motion of the first jaw701 and the second jaw702 in response to an actuation motion of the end tool700 of the surgical instrument for electrocautery ofFIG.41.

Referring toFIGS.61 and62, the first jaw701 and the second jaw702 are connected in an X-shaped structure, and the first jaw701 and the second jaw702 rotate relative to each other as the first jaw pulley711 and the second jaw pulley721 rotate with the fixed rotation shaft741 as the center of rotation, enabling an actuation motion.

In the end tool700 of the electric cauterization surgical instrument10 according to the second embodiment of the present disclosure, as the first jaw701 and the second jaw702 rotate relative to each other, a grip force may be amplified when the jaw rotation shaft70 le is moved forward/backward, particularly forward.

Referring toFIG.62, as the pulley711 and the pulley721 rotate in opposite directions with the first rotation shaft741 as the central axis of rotation, the first jaw701 and the second jaw702, which are respectively connected to the pulley711 and the pulley721, rotate in opposite directions and move away from each other, and thus the end tool700 may be in an open state.

Referring toFIGS.61 to65, it may be said that the tissue between the first jaw701 and the second jaw702 is cut as the cutting motion ofFIGS.63 to65 is performed in a state in which the first jaw701 and the second jaw702 are closed as shown inFIG.61.

Here, a first position shown inFIG.63 may be defined as a state in which the blade775 is drawn in toward a proximal end705 of the end tool as much as possible. Alternatively, the first position may also be defined as a state in which the blade775 is located adjacent to the pulley711/pulley712.

Meanwhile, a third position illustrated inFIG.65 may be defined as a state in which the blade775 is withdrawn toward a distal end704 of the end tool700 as much as possible. Alternatively, the third position may also be defined as a state in which the blade775 is spaced away from the pulley711/pulley712 as much as possible.

First, as shown inFIG.62, a tissue to be cut is located between the first jaw701 and the second jaw702 in a state in which the first jaw701 and the second jaw702 are opened, and then an actuation motion is performed to close the first jaw701 and the second jaw702 as shown inFIG.61.

Next, as shown inFIG.63, in a state in which the blade wire307 and the blade775 are located at the first position, currents of different polarities are applied to the first electrode751 and the second electrode752 to cauterize the tissue between the first jaw701 and the second jaw702. At this time, a generator (not shown) configured to supply power to the electrodes may itself perform monitoring of at least some of current, voltage, resistance, impedance, and temperature, and may stop supplying power when the cauterization is completed.

In the state in which the cauterization is completed as described above, when the blade wire307 moves sequentially in the directions of an arrow A1 ofFIG.64 and an arrow A2 ofFIG.65, the blade775 coupled to the blade wire307 moves from the first position at the proximal end705 of the end tool toward the third position at the distal end704 of the end tool, reaching the positions inFIGS.64 and65 in turn.

As such, the blade775 cuts the tissue located between the first jaw701 and the second jaw702 while moving in the X-axis direction.

However, it is to be understood that the linear motion of the blade775 here does not mean a motion in a completely straight line, but rather means a motion of the blade775 to the extent that the blade775 is able to cut the tissue while achieving a linear motion when viewed as a whole, even though the motion is not in a completely straight line, for example, the middle part of the straight line is bent by a certain angle or there is a section having a gentle curvature in a certain section.

Meanwhile, in this state, when the blade wire307 is pulled in the opposite direction, the blade775 coupled to the blade wire307 also returns to the first position.

According to the present disclosure, the multi-joint/multi-degree-of-freedom surgical instrument capable of pitch/yaw/actuation motions may also perform cauterizing and cutting motions.

Referring toFIGS.66 and67, views are illustrated in which a process of performing an opening and closing motion in a state in which the end tool700 of the electric cauterization surgical instrument10 ofFIG.41 is yaw-rotated by +90°.

Referring toFIG.66, the pulley711 and the pulley721 that faces the pulley711 may be rotated around the first rotation shaft741 due to the wires of the power transmission portion300 in the manipulation portion200. InFIG.66, when the pulley711 and the pulley721 rotate in opposite directions, the first jaw701 and the second jaw702 respectively coupled to the pulley711 and the pulley721 may rotate relative to each other in a direction of approaching each other to perform an actuation motion, and as shown inFIG.67, the first jaw701 and the second jaw702 may be in a closed state.

FIGS.66 and67 are views illustrating a process of performing an opening and closing motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.41 is yaw-rotated by −90°.

Referring toFIGS.66 and67, as the pulley711 and the pulley711 are yaw rotatable by −90° with the first rotation shaft741 as the central axis of rotation, and the pulley711 and the pulley711 rotates in different directions, an actuation motion is possible in which the first jaw701 and the second jaw702 respectively connected to the pulley711 and the pulley721 move closer or further away from each other.

Referring toFIGS.66 to69, a blade assembly, specifically, the guide tube770 is connected to the end tool700 at the other end portion, which is opposite one end portion connected to the connection portion400, and may be of constant length.

The guide tube770 may be gently curved with a predetermined radius of curvature when the end tool700, specifically, the first jaw701 and the second jaw702 rotate with the first rotation shaft741 as the central axis of rotation, and may stably provide a movement path for the blade wire307 to be movable between the distal end704 and the proximal end705 of the end tool700.

FIGS.70 and71 are views illustrating a path of the guide tube770 and a movement path of the blade775 during a cutting motion in a state in which the end tool700 of the surgical instrument for electrocautery ofFIG.41 is yaw-rotated by +90°.

Referring toFIGS.70 and71, the end tool700 of the electric cauterization surgical instrument10 according to the second embodiment of the present disclosure is formed such that the jaws701 and702 are able to perform a normal cutting motion even when the jaws are yaw-rotated by +90°.

Specifically, as the blade wire307 emerges from the inside of the guide tube770, and the blade775 connected to the blade wire307 moves in the direction of an arrow A, which is a direction from the proximal end705 toward the distal end704 of the end tool700, a cutting motion may be performed.

FIGS.72 and73 are views illustrating a process of performing an opening and closing motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.41 is pitch-rotated by −90°.FIGS.74 and75 are views illustrating a process of performing an opening and closing motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.41 is pitch-rotated by +90°.FIG.76 is a view illustrating a path of the guide tube in a state in which the end tool of the surgical instrument for electrocautery ofFIG.41 is pitch-rotated by −90°.FIGS.77 and78 are views illustrating a path of the guide tube and a movement path of the blade during a cutting motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.41 is pitch-rotated by −90°.FIG.79 is a perspective view illustrating the surgical instrument for electrocautery ofFIG.41 in a pitch-rotated and yaw-rotated state.FIGS.80 to82 are views illustrating the end tool of the surgical instrument for electrocautery ofFIG.41 performing a cutting motion in a state in which the end tool is pitch-rotated by −90° and simultaneously yaw-rotated by +90°.

FIGS.74 and75 are views illustrating a process of performing an opening and closing motion in a state in which the end tool700 of the surgical instrument for electrocautery ofFIG.41 is pitch-rotated by +90°.FIG.76 is a view illustrating a path of the guide tube770 in a state in which the end tool700 of the surgical instrument for electrocautery ofFIG.41 is pitch-rotated by −90°.FIGS.77 and78 are views illustrating a path of the guide tube and a movement path of the blade during a cutting motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.41 is pitch-rotated by −90°.

Referring toFIGS.72 to78, the end tool700 of the electric cauterization surgical instrument10 according to the second embodiment of the present disclosure is formed such that the jaws701 and702 are able to perform a cutting motion normally even when the jaws are pitch-rotated by −90° and +90°.

Meanwhile,FIG.79 is a view illustrating a state in which the jaws are pitch-rotated by −90° and simultaneously yaw-rotated by +90°, andFIGS.80 to82 are views illustrating a state in which the end tool of the surgical instrument for electrocautery ofFIG.41 performs a cutting motion in a state in which the end tool is pitch-rotated by −90° and simultaneously yaw-rotated by +90°.

Referring toFIGS.79 to82, the end tool700 of the electric cauterization surgical instrument10 according to the second embodiment of the present disclosure is formed such that the jaws701 and702 are able to perform a cutting motion normally even when the jaws are pitch-rotated by −90° and simultaneously yaw-rotated by +90°.

Modified Example of Second Embodiment-Disposing Auxiliary Pulley on End Tool Hub

Hereinafter, an end tool700 of a surgical instrument according to a modified example of the second embodiment of the present disclosure will be described. Here, the end tool700 of the surgical instrument according to the modified example of the second embodiment of the present disclosure is different from the end tool of the surgical instrument according to the second embodiment of the present disclosure described above in that the configuration of an end tool hub760′ and the configuration of auxiliary pulleys712 and722 are different. The configuration changed from the second embodiment as described above will be described in detail later.

FIGS.83 to85 are views illustrating the end tool of the surgical instrument for electrocautery according to the modified example of the second embodiment of the present disclosure.

Referring toFIGS.83 to85, the end tool700 of the modified example of the second embodiment of the present disclosure includes a pair of jaws for performing a grip motion, specifically a first jaw701 and a second jaw702, and here, each of the first jaw701 and the second jaw702 or a component encompassing the first jaw701 and the second jaw702 may be referred to as a jaw703.

The end tool700 according to the modified example of the second embodiment may include a pulley711, the pulley712, a pulley713, a pulley714, a pulley715, and a pulley716 that are associated with a rotational motion of the first jaw701. In addition, the end tool700 may include a pulley721, the pulley722, a pulley723, a pulley724, a pulley725, and a pulley726 that are associated with a rotational motion of the second jaw702.

Here, the pulleys facing each other are illustrated in the drawings as being formed parallel to each other, but the concept of the present disclosure is not limited thereto, and each of the pulleys may be variously formed with a position and a size suitable for the configuration of the end tool.

The end tool700 according to the modified example of the second embodiment of the present disclosure may further include the pulley712 and the pulley722 as compared to the end tool700 according to the second embodiment of the present disclosure illustrated with reference toFIG.43.

Referring toFIGS.84 and85, the pulley712 functions as an end tool first jaw auxiliary pulley, and the pulley722 functions as an end tool second jaw auxiliary pulley, and these two components may collectively be referred to as end tool jaw auxiliary pulleys or simply auxiliary pulleys.

In detail, the pulley712 and the pulley722, which are end tool jaw auxiliary pulleys, may be additionally provided on one side of the pulley711 and one side of the pulley721, respectively. In other words, the pulley712, which is an auxiliary pulley, may be disposed between the pulley711 and the pulley713/pulley714. In addition, the pulley722, which is an auxiliary pulley, may be disposed between the pulley721 and the pulley723/pulley724.

The pulley712 and the pulley722 may be formed to be rotatable independently of each other around a second rotation shaft742.

The pulley712 and the pulley722 may serve to increase rotation angles of the first jaw701 and the second jaw702, respectively, by coming into contact with a wire305, which is a first jaw wire, and a wire302, which is a second jaw wire, and changing the arrangement paths of the wire305 and the wire302 to a certain degree.

That is, when the auxiliary pulleys are not disposed, each of the first jaw701 and the second jaw702 may rotate only up to a right angle, but in the modified example of the second embodiment, by additionally providing the pulley712 and the pulley722, which are auxiliary pulleys, the effect of increasing the maximum rotation angle by a certain angle can be achieved.

This enables a motion in which two jaws of the end tool700 have to be spread apart for an actuation motion in a state in which the two jaws are yaw-rotated together by 90° in the clockwise or counterclockwise direction.

In other words, a feature of increasing the range of yaw rotation in which an actuation motion is possible may be obtained through the pulley712 and the pulley722. This will be described below in more detail.

When the auxiliary pulleys are not disposed, since the first jaw wire305 is fixedly coupled to the end tool first jaw pulley711, and the second jaw wire302 is fixedly coupled to the end tool second jaw pulley721, each of the end tool first jaw pulley711 and the end tool second jaw pulley721 may rotate up to 90°.

In this case, when the actuation motion is performed in a state in which the first jaw701 and the second jaw702 are located at a 90° line, the first jaw701 may be spread, but the second jaw702 may not be rotated beyond 90°. Accordingly, when the first jaw701 and the second jaw702 perform a yaw motion over a certain angle, there was a problem that an actuation motion is not smoothly performed.

In order to address such a problem, in the electric cauterization surgical instrument10 of the present disclosure, the pulley712 and the pulley722, which are auxiliary pulleys, are additionally disposed at one side of the pulley711 and one side of the pulley721, respectively. As described above, as the arrangement paths of the wire305, which is a first jaw wire, and the wire302, which is a second jaw wire, are changed to a certain degree by disposing the pulley712 and the pulley722, a tangential direction of the wires305 and302 is changed, and accordingly, a fastening member324 for coupling the wire302 and the pulley721 is additionally rotatable by a certain angle.

That is, a fastening member326, which is a coupling portion of the wire302 and the pulley721, is rotatable until being located on a common internal tangent of the pulley721 and the pulley722. Similarly, a fastening member323, which is a coupling portion of the wire305 and the pulley711, is rotatable until being located on a common internal tangent of the pulley711 and the pulley712, so that the range of rotation may be increased.

In other words, due to the pulley712 that is an auxiliary pulley, a wire301 and a wire305, which are two strands of the first jaw wire wound around the pulley712, are disposed at one side with respect to a plane perpendicular to the Y-axis and passing through the X-axis. Simultaneously, due to the pulley722, the wires302 and306, which are two strands of the second jaw wire wound around the pulley721, are disposed at the other side with respect to the plane perpendicular to the Y-axis and passing through the X-axis.

In other words, the pulley713 and the pulley714 are disposed at one side with respect to the plane perpendicular to the Y-axis and passing through the X-axis, and the pulley723 and the pulley724 are disposed at the other side with respect to the plane perpendicular to the Y-axis and passing through the X-axis.

In other words, the wire305 is located on the internal tangent of the pulley711 and the pulley712, and the rotation angle of the pulley711 is increased due to the pulley712. In addition, the wire302 is located on the internal tangent of the pulley721 and the pulley722, and the rotation angle of the pulley721 is increased due to the pulley722.

According to the present disclosure, the rotation radii of the first jaw701 and the second jaw702 increase, so that an effect of increasing a yaw motion range in which a normal opening/closing actuation motion can be performed may be obtained.

Referring toFIG.38, a first rotation shaft741 and a second rotation shaft742 may be inserted through the end tool hub760′ according to the modified example of the second embodiment of the present disclosure. Instead of respectively forming the first wire guide portion and the second wire guide portion on the surfaces of a first jaw pulley coupling portion762aand a second jaw pulley coupling portion762bfacing each other as in the end tool hub760 according to the second embodiment of the present disclosure, the pulley712 and the pulley722, which are configured as separate components from the end tool hub760′ and are able to be axially coupled to the second rotation shaft742 that is inserted through the end tool hub760′, are additionally provided and allowed to function as auxiliary pulleys.

The second rotation shaft742 inserted through the end tool hub760′ may include two shafts including a first sub-shaft and a second sub-shaft that face each other and are disposed to be spaced apart from each other by a certain distance. The second rotation shaft742 is divided into two parts and spaced apart from each other by a certain distance, and thus a guide tube770 may pass through the end tool hub760′ and a pitch hub750 through between the two parts.

Referring toFIG.83, the first rotation shaft741, the second rotation shaft742, a third rotation shaft743, and a fourth rotation shaft744 may be arranged sequentially from a distal end704 toward a proximal end705 of the end tool700. Accordingly, starting from the distal end704, the first rotation shaft741 may be referred to as a first pin, the second rotation shaft742 may be referred to as a second pin, the third rotation shaft743 may be referred to as a third pin, and the fourth rotation shaft744 may be referred to as a fourth pin.

As compared to the second embodiment, the end tool700 of the modified example of the second embodiment of the present disclosure has the same configuration as the end tool700 according to the second embodiment, except that the pulley721 and the pulley722, which are axially coupled to the end tool hub760′ by the second rotation shaft742, are provided as separate components instead of being integrally formed with a body portion761 in the end tool hub760′ and function as auxiliary pulleys, and thus a detailed description thereof will be omitted in the overlapping range.

Third Embodiment of Surgical Instrument for Electrocautery

FIG.86 is a perspective view illustrating a surgical instrument for electrocautery according to a third embodiment of the present disclosure.FIGS.87 to92 are plan views illustrating an end tool of the surgical instrument for electrocautery ofFIG.86.

Referring toFIG.86, an electric cauterization surgical instrument10 according to the third embodiment of the present disclosure includes an end tool800, a manipulation portion200, a power transmission portion300, and a connection portion400.

As compared to the electric cauterization surgical instrument10 according to the second embodiment, the electric cauterization surgical instrument10 according to the third embodiment of the present disclosure is different from in a configuration of the end tool800, specifically, a yaw hub880, an actuation link892, and the like, which will be described in detail below.

Referring toFIGS.86 and87, the end tool800 according to the third embodiment of the present disclosure is formed at the other end of the connection portion400, and performs necessary motions for surgery by being inserted into a surgical site. In an example of the end tool800, as illustrated inFIG.86, a pair of jaws803 for performing a grip motion may be used.

However, the concept of the present disclosure is not limited thereto, and various devices for performing surgery may be used as the end tool800. For example, a configuration of a cantilever cautery may also be used as the end tool800.

The end tool800 is connected to the manipulation portion200 by the power transmission portion300, and receives a driving force of the manipulation portion200 through the power transmission portion300 to perform a motion necessary for surgery, such as gripping, cutting, suturing, or the like.

Here, the end tool800 of the electric cauterization surgical instrument10 according to the third embodiment of the present disclosure is formed to be rotatable in at least one direction, and for example, the end tool800 may be formed to perform a pitch motion around a Y-axis ofFIG.86 and simultaneously perform a yaw motion and an actuation motion around a Z-axis ofFIG.86.

End Tool According to Third Embodiment

Hereinafter, the end tool800 of the electric cauterization surgical instrument10 ofFIG.86 will be described in more detail.

FIG.86 is a perspective view illustrating the surgical instrument for electrocautery according to the third embodiment of the present disclosure.FIGS.87 to92 are views illustrating the end tool of the surgical instrument for electrocautery ofFIG.86.

Here,FIG.87 illustrates a state in which an end tool hub860 and a pitch hub850 are coupled, andFIG.88 illustrates a state in which the end tool hub860, the yaw hub880, and the pitch hub850 are removed.FIG.89 illustrates a state in which the yaw hub880 and the end tool hub860 are connected to the end tool, andFIG.90 illustrates a state in which a first jaw801 and a second jaw802 are removed. Meanwhile,FIG.91 is a view mainly illustrating wires, andFIG.92 is a view mainly illustrating pulleys.

Referring toFIGS.87,88,91, and92, the end tool800 according to the third embodiment of the present disclosure may include a pair of jaws for performing a grip motion, that is, the first jaw801 and the second jaw802. Here, each of the first jaw801 and the second jaw802, or a component encompassing the first jaw801 and the second jaw802 may be referred to as the jaw803.

In addition, the end tool800 may include a pulley891, a pulley813, a pulley814, a pulley815, and a pulley816, which are associated with a rotational motion of the first jaw801. In addition, the end tool800 may include a pulley881, a pulley823, a pulley824, a pulley825, and a pulley826, which are associated with a rotational motion of the second jaw802.

Here, the pulleys facing each other are illustrated in the drawings as being formed parallel to each other, but the concept of the present disclosure is not limited thereto, and each of the pulleys may be variously formed with a position and a size suitable for the configuration of the end tool.

Referring toFIG.87, the end tool800 of the third embodiment of the present disclosure may include the end tool hub860, the pitch hub850, and the yaw hub880.

A first rotation shaft841, which will be described later, may be inserted through the end tool hub860, and the end tool hub860 may internally accommodate at least some of the pulley891 and the pulley881, which are axially coupled to the first rotation shaft841.

The end tool hub860 according to the third embodiment of the present disclosure is the same as the end tool hubs660 and760 according to the first and third embodiments, and thus a detailed description thereof will be omitted in the overlapping range.

Referring toFIG.87, the pitch hub850 may have a third rotation shaft843 and a fourth rotation shaft844, which will be described later, inserted therethrough, and may be axially coupled to a first pitch pulley portion863aand a second pitch pulley portion863bof the end tool hub860 by the third rotation shaft843. Accordingly, the end tool hub860 may be formed to be rotatable around the third rotation shaft843 with respect to the pitch hub850.

In addition, the pitch hub850 may internally accommodate at least some of the pulley813, the pulley814, the pulley823, and the pulley824 that are axially coupled to the third rotation shaft843. In addition, the pitch hub850 may internally accommodate at least some of the pulley815, the pulley816, the pulley825, and the pulley826 that are axially coupled to the fourth rotation shaft844.

One end portion of the pitch hub850 is connected to the end tool hub860, and the other end portion of the pitch hub850 is connected to the connection portion400.

Referring toFIG.87, the first rotation shaft841 may function as an end tool jaw pulley rotation shaft, the third rotation shaft843 may function as an end tool pitch rotation shaft, and the fourth rotation shaft844 may function as an end tool pitch auxiliary rotation shaft of the end tool100.

Here, each of the rotation shafts may be divided into two parts, and the respective divided rotation shafts may be spaced apart from each other. Each of the rotation shafts is formed by being divided into two parts as described above to allow a guide tube870 to pass through the end tool hub860 and the pitch hub850.

That is, the guide tube870 may pass between a first sub-shaft and a second sub-shaft of each of the rotation shafts. This will be described in more detail later. Here, the first sub-shaft and the second sub-shaft may be disposed on the same axis or may be disposed to be offset to a certain degree.

Meanwhile, it is illustrated in the drawings that each of the rotation shafts is formed by being divided into two parts, but the concept of the present disclosure is not limited thereto. That is, each of the rotation shafts is formed to be curved in the middle such that an escape path for the guide tube870 is formed.

Referring toFIGS.87 and88, an actuation rotation shaft845 may be further provided in the end tool800 according to the third embodiment of the present disclosure. In detail, the actuation rotation shaft845 may be provided in a coupling portion of the first jaw801 and the second jaw802, and the second jaw802 rotates around the actuation rotation shaft845 while the first jaw801 is fixed, thereby performing an actuation motion. Here, the actuation rotation shaft845 may be disposed closer to a distal end804 than the first rotation shaft841 is.

Here, in the end tool800 of the third embodiment of the present disclosure, the first rotation shaft841, which is a yaw rotation shaft, and the actuation rotation shaft845 are provided separately rather than as the same shaft.

That is, by forming the first rotation shaft841, which is a rotation shaft of the pulley881/pulley891 that are jaw pulleys and a rotation shaft of a yaw motion, and the actuation rotation shaft845, which is a rotation shaft of the second jaw802 with respect to the first jaw801 and a rotation shaft of an actuation motion, to be spaced apart from each other by a certain distance, a space in which the guide tube870 and the blade wire307 accommodated therein can be gently bent may be secured. This actuation rotation shaft845 will be described in more detail later.

The pulley891 functions as an end tool first jaw pulley, and the pulley881 functions as an end tool second jaw pulley. The pulley891 may also be referred to as a first jaw pulley, and the pulley881 may also be referred to as a second jaw pulley, and these two components may collectively be referred to as end tool jaw pulleys or simply jaw pulleys.

The pulley891 and the pulley881, which are end tool jaw pulleys, are formed to face each other, and are formed to be rotatable independently of each other around the first rotation shaft841 which is an end tool jaw pulley rotation shaft.

In this case, the pulley891 and the pulley881 are formed to be spaced apart from each other by a certain distance, and a blade assembly may be accommodated therebetween.

In other words, the blade assembly including the guide tube870 may be disposed between the pulley891 and the pulley881.

Meanwhile, the end tool800 of the third embodiment of the present disclosure may further include components such as a first electrode851, a second electrode852, the guide tube870, and a blade875 in order to perform a cauterizing motion and a cutting motion.

Here, components related to the driving of the blade, such as the guide tube870 and the blade875, may be collectively referred to as a blade assembly. In one modified example of the present disclosure, by disposing the blade assembly including the blade875 between the pulley891, which is a first jaw pulley, and the pulley881, which a second jaw pulley, the end tool800 is able to perform the cutting motion using the blade in addition to the pitch and yaw motions. Components for performing a cauterizing motion and a cutting motion in the present embodiment are substantially the same as those described in the first and second embodiments, and thus a detailed description thereof will be omitted herein.

The electric cauterization surgical instrument10 according to the third embodiment of the present disclosure may include a wire301, a wire302, the wire303, the wire304, a wire305, a wire306, and a blade wire307, as in the first embodiment of the present disclosure.

(Jaw-Link-Pulley Connection Structure)

Hereinafter, a jaw-link-pulley connection structure in the end tool800 according to the third embodiment of the present disclosure will be described in more detail.

Referring toFIGS.87 to101, the end tool800 of the third embodiment of the present disclosure includes the first jaw801, the second jaw802, the yaw hub880, an actuation link592, the first jaw pulley891, and the second jaw pulley881. Hereinafter, the pulley891 is referred to as the first jaw pulley891, and the pulley881 is referred to as the second jaw pulley881.

Referring toFIGS.97 to100, the first jaw pulley891 may be formed as a kind of multi-layered pulley. In other words, the first jaw pulley891 may be formed in a form in which two pulleys are combined, and two grooves may be formed on an outer circumferential surface of the first jaw pulley891.

In detail, a first coupling portion891amay be formed on one surface of the first jaw pulley891, and a second coupling portion891bmay be formed in the shape of a groove on the other surface opposite to the one surface on which the first coupling portion891ais formed.

Here, the positions of the first coupling portion891aand the second coupling portion891bare positions allowing the wire301 and the wire305 to overlap each other. In other words, the first coupling portion891aand the second coupling portion891bmay be formed so that at least some of the wire302 and the wire306 wound around the first jaw pulley891 overlap each other.

In other words, the first coupling portion891aand the second coupling portion891bare asymmetrically disposed when viewed on an XY plane, so that the first coupling portion891aand the second coupling portion891bare disposed to be biased in any one region of the second jaw pulley891.

In other words, the first coupling portion891amay be formed at a position at which the wire301 may be wound around the outer circumferential surface of the first jaw pulley891 such that the central angle is an angle between 90° and 360°. Similarly, the second coupling portion891bmay be formed at a position at which the wire305 may be wound around the outer circumferential surface of the second jaw pulley891 such that the central angle is an angle between 90° and 360°.

In addition, one end portion of the wire301 is coupled to a fastening member334a, which may be coupled to the first coupling portion891aof the first jaw pulley891. One end portion of the wire305 is coupled to a fastening member334b, which may be coupled to the second coupling portion891bof the first jaw pulley891.

When the wire301 is referred to as a first jaw wire R and the wire305 is referred to as a first jaw wire L, the first coupling portion891ato which the first jaw wire R(301) is coupled is formed on a side opposite to one side to which the first jaw wire R(301) is input, so that a rotation angle of the first jaw pulley891 is increased by increasing the length of the first jaw wire R(305) wound around the first jaw pulley891.

Also, the second coupling portion891bto which the first jaw wire L(302) is coupled is formed on one side opposite to the other side to which the first jaw wire L(302) is input, so that the rotation angle of the first jaw pulley891 may be increased by increasing the length of the first jaw wire L(302) wound around the first jaw pulley891.

A rotation radius of the second jaw pulley891 may be increased due to the first coupling portion891aand the second coupling portion891b. In addition, by increasing the length of the wire301/wire305 wound around the first jaw pulley891 as described above, a long stroke of the actuation link892 may be secured. This will be described in more detail later.

Referring toFIG.90, the yaw hub880 is located between the first and second jaws801 and802 and the first and second jaw pulleys891 and881, and may include a yaw hub body882.

The first jaw pulley891 may be formed at one end portion of the yaw hub880. A guide slit883 may be formed on the other end portion of the yaw hub880 in a longitudinal direction. A guide pin893 formed to protrude from the actuation link892 to be described later may be fitted into the guide slit883.

Referring toFIGS.90 and93, a through hole through which the actuation rotation shaft845 is inserted may be formed in the yaw hub880 at one side of the guide slit883. Referring toFIG.93, the second jaw pulley881 is integrally formed on one side of the yaw hub880, but the present disclosure is not limited thereto, and various modifications are possible.

Although not shown in the drawings, it is also possible that the second jaw pulley881 and the yaw hub880 are each formed as a separate member, and the second jaw pulley881 may be fixedly coupled to the yaw hub880, specifically, the yaw hub body882.

In addition, two divided first rotation shafts841 may be inserted through the first jaw pulley891 and the second jaw pulley881, respectively.

Since the second jaw pulley881 is integrally formed with or fixedly coupled to the yaw hub880 as described above, the yaw hub880 does not rotate with respect to the second jaw pulley881, and when the second jaw pulley881 rotates around the first rotation shaft841, the yaw hub580 may also rotate around the first rotation shaft841 together with the second jaw pulley881.

Referring toFIGS.90 and91, the actuation rotation shaft845 may be disposed on the yaw hub880. The actuation rotation shaft845 may be divided into two parts, which may be disposed to be spaced apart from each other by a certain distance, and the guide tube870, the blade wire307 accommodated in the guide tube870, and the blade875 may pass through a space formed between the two divided actuation rotation shafts845.

Referring toFIG.90, the yaw hub880, specifically, a guide slit883 formed in the yaw hub body882 may be formed to extend in a longitudinal direction between the actuation rotation shaft845 and the yaw rotation shaft841.

Referring toFIG.90, the guide slit883 may be formed to have the same width in the longitudinal direction, and the guide pin893 formed to protrude from the actuation link892 is movable, specifically, linearly movable in the guide slit883.

Referring toFIG.93, on the other side of the yaw hub880 opposite to one side thereof on which the second jaw pulley881 is formed, an actuation pulley coupling portion885 may be formed to protrude so as to be coupled to the first jaw pulley891.

The actuation pulley coupling portion885 may share a central axis with the yaw rotation shaft841. However, the present disclosure is not limited thereto, and various modifications are possible, including spacing apart and placing the actuation pulley coupling portion885 and the yaw hub880 side by side.

Referring toFIG.101, the actuation link892 may be formed to extend in a longitudinal direction. The actuation link892 may include a link body892aand a bending portion892b. The link body892ais a portion formed to extend in the longitudinal direction, and the bending portion892bmay be connected to the link body892awith at least one bend.

Accordingly, one side of the actuation link892 in which the bending portion892bis located may be formed in a “U”-shape.

Referring toFIG.101, a pin coupling hole (no reference number is assigned) may be formed in one surface of the bending portion892bthat is disposed in parallel with the link body892ato be spaced apart therefrom by a certain distance.

A pin coupling hole may also be formed in one surface of the link body892afacing the bending portion892bto correspond to the pin coupling hole of the bending portion892b. The guide pin893 may be coupled to the pin coupling hole. A plurality of guide pins893 may be provided, and may be coupled to the pin coupling holes formed in the respective facing surfaces of the bending portion892band the link body892a.

The plurality of guide pins893 may be disposed to be spaced apart from each other by a certain distance, and one side region of the U-shaped actuation link892 formed with the bending portion892band the link body892amay provide a movement path so that the guide tube870 can pass therethrough. Due to the ‘U’ shaped region formed by the bending portion892band the link body892a, the movement path of the guide tube870 moving inside the yaw hub880 and the end tool hub860 is not disturbed when the actuation link892 linearly moves.

Referring toFIG.101, a link through-hole892cmay be formed on the other side of the link body892aopposite to one side to which the bending portion892bis connected. A protrusion891cformed on the first jaw pulley891 may be axially coupled to and fitted into the link through-hole892c.

Accordingly, when the first jaw pulley891 rotates, the actuation link892 moves while rotating around the protrusion891c.

The guide pin893 provided in the actuation link892 is fitted into the guide slit883 formed in the yaw hub880 and is movable along the shape of the guide slit883.

The guide pin893 passing through the guide slit883 may be fitted into each of slots801aand802arespectively formed in the first jaw801 and the second jaw802. The first jaw801 and the second jaw802 have an X-shaped structure, and the guide pin893 may be fitted into the slot801aformed in the first jaw801 and the slot801bformed in the second jaw802 at the same time.

The first jaw801 and the second jaw802 may perform an actuation motion while moving away from or close to each other with the actuation rotation shaft845 as the center of rotation.

Referring toFIGS.102 to104, when the first jaw pulley891 rotates in an A1 direction, the actuation link892 axially coupled to the protrusion891cformed in the first jaw pulley891 is moved in a B1 direction. Specifically, the guide pin893 provided in the actuation link892 is moved linearly along the guide slit883 formed in the yaw hub880, and the guide pin893 is fitted into the slots801aand802arespectively formed in the first jaw801 and the second jaw802, so that the guide pin893 pushes the first jaw801 and the second jaw802. Thus, as the actuation link892 is moved, the first jaw801 and the second jaw802 may perform an actuation motion while rotating around the actuation rotation shaft845 as the center of rotation.

Referring toFIG.103, as the actuation link892 is moved toward the distal end, the first jaw801 and the second jaw802 may perform an actuation motion in C1 directions around the actuation rotation shaft845 along the C1 directions.

Referring toFIG.104, when the guide pin893 is moved as much as possible toward the distal end in the slots801aand802arespectively formed in the first jaw801 and the second jaw802, the first jaw801 and the second jaw802 may be further spread apart in C2 directions.

In addition, the first jaw pulley891 is formed in a multi-layered structure, and the first jaw wires301 and305 are wound so that the first jaw wires301 and305 overlap in different layers, and as a result, the length of the winding on the first jaw pulley891 can be increased, and the rotation angle of the first jaw pulley891 can be increased.

FIGS.105 to108 are perspective views illustrating an actuation motion of the end tool of the surgical instrument for electrocautery ofFIG.86. The guide pin893 provided in the actuation link892 is movable along the slots801aand802arespectively formed in the first jaw801 and the second jaw802, and accordingly, the first jaw801 and the second jaw802 may perform an actuation motion with the actuation rotation shaft845 as the central axis of rotation.

FIGS.109 to111 are partial cross-sectional views illustrating an operation of the blade of the end tool of the surgical instrument for electrocautery ofFIG.86. The operation of the blade875 is the same as those of the first and second embodiments, and thus a detailed description thereof will be omitted in the overlapping range.

FIGS.112 and113 are bottom views illustrating a process of performing an opening and closing motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.86 is yaw-rotated by +90°.

The guide slit883 formed in the yaw hub880 may be formed in a straight line direction, and the actuation rotation shaft845 may be disposed along a longitudinal central axis of the guide slit883.

The slots801aand802arespectively formed in the first jaw801 and the second jaw802 may be formed to be inclined at a certain angle with the longitudinal central axis of the guide slit883 formed in the yaw hub880.

This causes the first jaw801 and second jaw803 to spread apart from each other as shown inFIG.113 when the actuation link892, specifically the guide pin893 that is moved by receiving power from the first jaw pulley891, is moved forward toward the actuation rotation shaft845 while the actuation rotation shaft845 remains fixed.

Referring toFIGS.114 and115, the first jaw pulley891 rotates in a state in which the end tool of the surgical instrument for electrocautery ofFIG.86 is yaw-rotated by +90°, and the guide pin893 provided in the actuation link892 connected to the first jaw pulley891 is moved through the guide slit883 formed in the yaw hub880 and the slots801aand802arespectively formed in the first jaw801 and the second jaw802, so that an actuation motion can be performed even in a yaw rotated state.

Referring toFIGS.116 to125, there is room for problems when the guide tube870 is in contact with the actuation link892 while the end tool800 is yaw-rotated, but the actuation link892 of the present disclosure includes the link body892aand the bending portion892bconnected thereto, which form a “U” shape, to prevent the contact with the guide tube870, allowing the blade wire307 and the guide tube870 to move stably with respect to yaw, pitch, and actuation motions of the end tool800.

Referring toFIGS.126 to136, the end tool800 of the electric cauterization surgical instrument10 according to the third embodiment of the present disclosure is formed such that the jaws801 and802 are able to perform a cutting motion normally even when the jaws are pitch-rotated and simultaneously yaw-rotated.

Here, in the end tool800 of the third embodiment of the present disclosure, a pin/slot-type structure is employed to secure a grip force in the actuation motion.

In detail, in the pin/slot-type structure, the actuation link892 must move a longer distance to rotate the first jaw801 by the same amount (that is, the actuation link892 needs to have a long stroke). In addition, in order for the actuation link590 to move a longer distance, the first jaw pulley891 should rotate further. In other words, when the first jaw pulley891 rotates further to rotate the first jaw801 by the same amount, a greater force may be applied to the first jaw801 by as much as the first jaw pulley891 rotates further, so that a grip force in the actuation motion may be amplified.

In addition, in order to rotate the first jaw pulley891 further as described above, the first jaw pulley891 is formed in a multi-layered structure as described above to make the lengths of the wires301 and305 wound around the first jaw pulley891 to be longer, thereby securing a long stroke of the actuation link892.

Modified Example of Third Embodiment-Disposing Auxiliary Pulley on End Tool Hub

Hereinafter, an end tool800 of a surgical instrument according to a modified example of the third embodiment of the present disclosure will be described. Here, the end tool300 of the surgical instrument according to the modified example of the third embodiment of the present disclosure is different from the end tool of the surgical instrument according to the third embodiment of the present disclosure described above in that the configuration of an end tool hub860′ and the configuration of auxiliary pulleys812 and822 are different. The configuration changed from the third embodiment as described above will be described in detail later.

FIGS.137 to139 are views illustrating the end tool of the surgical instrument for electrocautery according to the modified example of the third embodiment of the present disclosure.

Referring toFIGS.137 and138, the end tool800 of the modified example of the third embodiment of the present disclosure includes a pair of jaws for performing a grip motion, specifically a first jaw801 and a second jaw802, and here, each of the first jaw801 and the second jaw802 or a component encompassing the first jaw801 and the second jaw802 may be referred to as a jaw803.

The end tool800 according to the modified example of the third embodiment may include a pulley811, the pulley812, a pulley813, a pulley814, a pulley815, and a pulley816 that are associated with a rotational motion of the first jaw801. In addition, the end tool800 may include a pulley821, the pulley822, a pulley823, a pulley824, a pulley825, and a pulley826 that are associated with a rotational motion of the second jaw802.

Here, the pulleys facing each other are illustrated in the drawings as being formed parallel to each other, but the concept of the present disclosure is not limited thereto, and each of the pulleys may be variously formed with a position and a size suitable for the configuration of the end tool.

The end tool800 according to the modified example of the third embodiment of the present disclosure may further include the pulley812 and the pulley822 as compared to the end tool800 according to the third embodiment of the present disclosure illustrated with reference toFIG.86.

Referring toFIGS.137 to139, the pulley812 functions as an end tool first jaw auxiliary pulley, and the pulley822 functions as an end tool second jaw auxiliary pulley, and these two components may collectively be referred to as end tool jaw auxiliary pulleys or simply auxiliary pulleys.

In detail, the pulley812 and the pulley822, which are end tool jaw auxiliary pulleys, may be additionally provided on one side of the pulley811 and one side of the pulley821, respectively. In other words, the pulley812, which is an auxiliary pulley, may be disposed between the pulley811 and the pulley813/pulley814. In addition, the pulley822, which is an auxiliary pulley, may be disposed between the pulley821 and the pulley823/pulley824.

The pulley812 and the pulley822 may be formed to be rotatable independently of each other around a second rotation shaft842.

The pulley812 and the pulley822 may serve to increase rotation angles of the first jaw801 and the second jaw802, respectively, by coming into contact with a wire305, which is a first jaw wire, and a wire302, which is a second jaw wire, and changing the arrangement paths of the wire305 and the wire302 to a certain degree.

That is, when the auxiliary pulleys are not disposed, each of the first jaw801 and the second jaw802 may rotate only up to a right angle, but in the modified example of the third embodiment, by additionally providing the pulley812 and the pulley822, which are auxiliary pulleys, the effect of increasing the maximum rotation angle by a certain angle can be achieved.

This enables a motion in which two jaws of the end tool800 have to be spread apart for an actuation motion in a state in which the two jaws are yaw-rotated together by 90° in the clockwise or counterclockwise direction.

In other words, a feature of increasing the range of yaw rotation in which an actuation motion is possible may be obtained through the pulley812 and the pulley822. This will be described below in more detail.

When the auxiliary pulleys are not disposed, since the first jaw wire305 is fixedly coupled to the end tool first jaw pulley811, and the second jaw wire302 is fixedly coupled to the end tool second jaw pulley821, each of the end tool first jaw pulley811 and the end tool second jaw pulley821 may rotate up to 90°.

In this case, when the actuation motion is performed in a state in which the first jaw801 and the second jaw802 are located at a 90° line, the first jaw801 may be spread, but the second jaw802 may not be rotated beyond 90°. Accordingly, when the first jaw801 and the second jaw802 perform a yaw motion over a certain angle, there was a problem that an actuation motion is not smoothly performed.

In order to address such a problem, in the electric cauterization surgical instrument10 of the present disclosure, the pulley812 and the pulley822, which are auxiliary pulleys, are additionally disposed at one side of the pulley811 and one side of the pulley821, respectively. As described above, as the arrangement paths of the wire305, which is a first jaw wire, and the wire302, which is a second jaw wire, are changed to a certain degree by disposing the pulley812 and the pulley822, a tangential direction of the wires305 and302 is changed, and accordingly, a fastening member324 for coupling the wire302 and the pulley821 is additionally rotatable by a certain angle.

That is, a fastening member326, which is a coupling portion of the wire302 and the pulley821, is rotatable until being located on a common internal tangent of the pulley821 and the pulley822. Similarly, a fastening member323, which is a coupling portion of the wire305 and the pulley811, is rotatable until being located on a common internal tangent of the pulley811 and the pulley812, so that the range of rotation may be increased.

In other words, due to the pulley812 that is an auxiliary pulley, the wires301 and305, which are two strands of the first jaw wire wound around the pulley812, are disposed at one side with respect to a plane perpendicular to the Y-axis and passing through the X-axis. Simultaneously, due to the pulley822, the wires302 and306, which are two strands of the second jaw wire wound around the pulley821, are disposed at the other side with respect to the plane perpendicular to the Y-axis and passing through the X-axis.

In other words, the pulley813 and the pulley814 are disposed at one side with respect to the plane perpendicular to the Y-axis and passing through the X-axis, and the pulley823 and the pulley824 are disposed at the other side with respect to the plane perpendicular to the Y-axis and passing through the X-axis.

In other words, the wire305 is located on the internal tangent of the pulley811 and the pulley812, and the rotation angle of the pulley811 is increased due to the pulley812. In addition, the wire302 is located on the internal tangent of the pulley821 and the pulley822, and the rotation angle of the pulley821 is increased due to the pulley822.

According to the present disclosure, the rotation radii of the first jaw801 and the second jaw802 increase, so that an effect of increasing a yaw motion range in which a normal opening/closing actuation motion can be performed may be obtained.

As compared to the third embodiment, the end tool800 of the modified example of the third embodiment of the present disclosure has the same configuration as the end tool800 according to the third embodiment, except that the pulley821 and the pulley822, which are axially coupled to the end tool hub860′ by the second rotation shaft842, are provided as separate components instead of being integrally formed with a body portion861 in the end tool hub860′ and function as auxiliary pulleys, and thus a detailed description thereof will be omitted in the overlapping range

Fourth Embodiment of Surgical Instrument for Electrocautery

FIG.140 is a perspective view illustrating a surgical instrument for electrocautery according to a fourth embodiment of the present disclosure.FIGS.141 to146 are views illustrating an end tool of the surgical instrument for electrocautery ofFIG.140.FIG.147 is a perspective view illustrating an end tool hub of the surgical instrument for electrocautery ofFIG.140.FIGS.148 and149 are cut-away perspective views of the end tool hub ofFIG.147.FIGS.150 and151 are perspective views illustrating the end tool hub ofFIG.147.FIG.152 is a side view illustrating the end tool hub ofFIG.147 and a guide tube.FIG.153 is a plan view illustrating the end tool hub ofFIG.147 and the guide tube.FIG.154 is a perspective view illustrating an actuation hub of the surgical instrument for electrocautery ofFIG.140.FIG.155 is a cut-away perspective view of the actuation hub ofFIG.154.FIG.156 is an exploded perspective view illustrating the end tool of the surgical instrument for electrocautery ofFIG.140.FIG.157 is a perspective view illustrating a first jaw of the end tool of the surgical instrument for electrocautery ofFIG.140.FIG.158 is a perspective view illustrating a second jaw of the end tool of the surgical instrument for electrocautery ofFIG.140.FIG.159 is a perspective view illustrating a first jaw pulley of the surgical instrument for electrocautery ofFIG.140.FIG.160 is a plan view illustrating an opening and closing motion of the first jaw of the end tool of the surgical instrument for electrocautery ofFIG.140.FIG.161 is a plan view illustrating an opening and closing motion of the second jaw of the end tool of the surgical instrument for electrocautery ofFIG.140.FIG.162 is a plan view illustrating an opening and closing motion of the first jaw and the second jaw of the end tool of the surgical instrument for electrocautery ofFIG.140.

Referring toFIGS.140 to162 and the like, an electric cauterization surgical instrument10 according to the fourth embodiment of the present disclosure includes an end tool1100, a manipulation portion200, a power transmission portion300, and a connection portion400.

Here, the connection portion400 is formed in the shape of a hollow shaft, and one or more wires and electric wires may be accommodated therein. The manipulation portion200 is coupled to one end portion of the connection portion400, the end tool1100 is coupled to the other end portion thereof, and the connection portion400 may serve to connect the manipulation portion200 and the end tool1100. Here, the connection portion400 of the electric cauterization surgical instrument10 according to the fourth embodiment of the present disclosure includes a straight portion401 and a bent portion402, wherein the straight portion401 is formed at a side coupled to the end tool1100, and the bent portion402 is formed at a side to which the manipulation portion200 is coupled. As such, since the end portion of the connection portion400 at the side of the manipulation portion200 is formed to be bent, a pitch manipulation portion201, a yaw manipulation portion202, and an actuation manipulation portion203 may be formed along an extension line of the end tool1100 or adjacent to the extension line. In other words, it may be said that the pitch manipulation portion201 and the yaw manipulation portion202 are at least partially accommodated in a concave portion formed by the bent portion402. Due to the above-described shape of the bent portion402, the shapes and motions of the manipulation portion200 and the end tool1100 may be further intuitively matched with each other.

Meanwhile, a plane on which the bent portion402 is formed may be substantially the same as a pitch plane, that is, an XZ plane ofFIG.140. As such, as the bent portion402 is formed on substantially the same plane as the XZ plane, interference with the manipulation portion may be reduced. Of course, for intuitive motions of the end tool and the manipulation portion, any form other than the XZ plane may be possible.

Meanwhile, a connector410 may be formed on the bent portion402. The connector410 may be connected to an external power supply (not shown), and the connector410 may be connected to a jaw1103 through electric wires411 and412 to transfer electrical energy supplied from the external power supply (not shown) to the jaw1103. Here, the connector410 may be of a bipolar-type having two electrodes, or the connector410 may be of a monopolar type having one electrode.

The manipulation portion200 is formed at the one end portion of the connection portion400 and provided as an interface to be directly controlled by a medical doctor, for example, a tongs shape, a stick shape, a lever shape, or the like, and when the medical doctor controls the manipulation portion200, the end tool1100, which is connected to the interface and inserted into the body of a surgical patient, performs a certain motion, thereby performing surgery. Here, the manipulation portion200 is illustrated inFIG.140 as being formed in a handle shape that is rotatable while the finger is inserted therein, the concept of the present disclosure is not limited thereto, and various types of manipulation portions that are connected to the end tool1100 and manipulate the end tool1100 may be possible.

The end tool1100 is formed on the other end portion of the connection portion400, and performs necessary motions for surgery by being inserted into a surgical site. In an example of the end tool1100 described above, as shown inFIG.140, a pair of jaws1103 for performing a grip motion may be used. However, the concept of the present disclosure is not limited thereto, and various devices for performing surgery may be used as the end tool1100. For example, a configuration of a cantilever cautery may also be used as the end tool. The end tool1100 is connected to the manipulation portion200 by the power transmission portion300, and receives a driving force of the manipulation portion200 through the power transmission portion300 to perform a motion necessary for surgery, such as gripping, cutting, suturing, or the like.

Here, the end tool1100 of the electric cauterization surgical instrument10 according to the fourth embodiment of the present disclosure is formed to be rotatable in at least one direction, for example, the end tool1100 may perform a pitch motion around a Y-axis ofFIG.140 and simultaneously perform a yaw motion and an actuation motion around a Z-axis ofFIG.140.

The power transmission portion300 may connect the manipulation portion200 to the end tool1100, transmit the driving force of the manipulation portion200 to the end tool1100, and include a plurality of wires, pulleys, links, sections, gears, or the like.

The end tool1100, the manipulation portion200, the power transmission portion300, and the like of the electric cauterization surgical instrument10 ofFIG.140 will be described in detail later.

(Power Transmission Portion)

Hereinafter, the power transmission portion300 of the electric cauterization surgical instrument10 ofFIG.140 will be described in more detail.

Referring toFIGS.140 to146 and the like, the power transmission portion300 of the electric cauterization surgical instrument10 according to an embodiment of the present disclosure may include a wire301, a wire302, a wire303, a wire304, a wire305, a wire306, and a blade wire307.

Here, the wire301 and the wire305 may be paired to serve as first jaw wires. The wire302 and the wire306 may be paired to serve as second jaw wires. Here, the components encompassing the wires301 and305, which are first jaw wires, and the wires302 and306, which are second jaw wires, may be referred to as jaw wires. In addition, the wires303 and304 may be paired to serve as pitch wires.

In addition, the power transmission portion300 of the electric cauterization surgical instrument10 according to an embodiment of the present disclosure may include a fastening member321, a fastening member322, a fastening member323, a fastening member324, a fastening member326, and a fastening member327 that are coupled to respective end portions of the wires to respectively couple the wires and the pulleys. Here, each of the fastening members may have various shapes as necessary, such as a ball shape, a tube shape, and the like.

Here, at the end tool1100 side, the fastening member321/fastening member322 may serve as pitch wire-end tool fastening members, the fastening member323 may serve as a first jaw wire-end tool fastening member, and the fastening member326 may serve as a second jaw wire-end tool fastening member.

Further, at the manipulation portion200 side, the fastening member324 may serve as a first jaw wire-manipulation portion fastening member, and the fastening member327 may serve as a second jaw wire-manipulation portion fastening member. In addition, although not shown in the drawings, a pitch wire-manipulation portion fastening member and a blade wire-manipulation portion fastening member may be further formed at the manipulation portion200 side.

The coupling relationship between the wires, the fastening members, and the respectively pulleys will be described in detail as follows.

First, the wires301 and305, which are first jaw wires, may be a single wire. The fastening member323, which is a first jaw wire-end tool fastening member, is inserted at an intermediate point of the first jaw wire, which is a single wire, and the fastening member323 is crimped and fixed, and then, both strands of the first jaw wire centered on the fastening member323 may be referred to as the wire301 and the wire305, respectively.

Alternatively, the wires301 and305, which are first jaw wires, may also be formed as separate wires, and connected by the fastening member323.

In addition, by coupling the fastening member323 to a pulley1111, the wires301 and305 may be fixedly coupled to the pulley1111. This allows the pulley1111 to rotate as the wires301 and305 are pulled and released.

Meanwhile, the first jaw wire-manipulation portion fastening member324 may be coupled to the other end portions of the wires301 and305, which are opposite to one end portions to which the fastening member323 is fastened.

In addition, by coupling the first jaw wire-manipulation portion fastening member324 to a pulley211, the wires301 and305 may be fixedly coupled to the pulley211. As a result, when the pulley211 is rotated by a motor or human power, the wire301 and the wire305 are pulled and released, allowing the pulley1111 of the end tool1100 to rotate.

In the same manner, the wire302 and the wire306, which are second jaw wires, are coupled to each of the fastening member326, which is a second jaw wire-end tool fastening member, and the second jaw wire-manipulation portion fastening member327. In addition, the fastening member326 is coupled to a pulley1121, and the second jaw wire-manipulation portion fastening member is coupled to a pulley220. As a result, when the pulley220 is rotated by a motor or a human force, the pulley1121 of the end tool1100 may be rotated as the wire302 and the wire306 are pulled and released.

In the same manner, the wire304, which is a pitch wire, is coupled to the fastening member321, which is a pitch wire-end tool fastening member, and the pitch wire-manipulation portion fastening member (not shown). In addition, the wire303, which is a pitch wire, is coupled to a fastening member322, which is a pitch wire-end tool fastening member, and the pitch wire-manipulation portion fastening member (not shown).

In addition, the fastening member321 is coupled to a first pitch pulley portion1163aof an end tool hub1160, the fastening member322 is coupled to a second pitch pulley portion1163bof the end tool hub1160, and the pitch wire-manipulation portion fastening member (not shown) is coupled to a pulley231. As a result, when the pulley231 is rotated by a motor or human force, the wire303 and the wire304 are pulled and released, allowing the end tool hub1160 of the end tool1100 to rotate.

Meanwhile, one end portion of the blade wire307 is coupled to a blade1175 to be described later, and the other end portion thereof is coupled to a blade manipulation portion260 of the manipulation portion200. By the manipulation of the blade manipulation portion260, a cutting motion may be performed as the blade wire307 is moved from a proximal end1105 toward a distal end1104 of the end tool1100, or the blade wire307 may return from the distal end1104 toward the proximal end1105 of the end tool1100.

At this time, at least a part of the blade wire307 may be accommodated in a guide tube1170 to be described later. Accordingly, when the guide tube1170 is bent in response to a pitch motion or yaw motion of the end tool1100, the blade wire307 accommodated therein may also be bent together with the guide tube1170. The guide tube1170 will be described in more detail later.

In addition, the blade wire307 is formed in a longitudinal direction of the connection portion400 to be linearly movable in the connection portion400. In addition, since one end portion of the blade wire307 is coupled to the blade1175, when the blade wire307 is linearly moved in the longitudinal direction of the connection portion400, the blade1175 connected thereto is also linearly moved. That is, when the blade wire307 is linearly moved in the longitudinal direction of the connection portion400, a cutting motion is performed as the blade1175 connected thereto is moved toward the distal end1104 or the proximal end1105 of the end tool1100. This will be described in more detail later.

(End Tool)

Hereinafter, the end tool1100 of the electric cauterization surgical instrument10 ofFIG.140 will be described in more detail.

FIG.140 is a perspective view illustrating the surgical instrument for electrocautery according to the fourth embodiment of the present disclosure.FIGS.141 to146 are views illustrating the end tool of the surgical instrument for electrocautery ofFIG.140.

Here,FIG.141 illustrates a state in which the end tool hub1160 and a pitch hub1150 are coupled, andFIG.142 illustrates a state in which the end tool hub1160 and pitch hub1150 are removed.FIG.143 illustrates a state in which a first jaw1101 and a second jaw1102 are removed, andFIG.144 illustrates a state in which the first jaw1101, the second jaw1102, the pulley1111, the pulley1121, and the like are removed. Meanwhile,FIG.145 is a view mainly illustrating the wires, andFIG.146 is a view mainly illustrating the pulleys.

Referring toFIGS.140 to162 and the like, the end tool1100 of the fourth embodiment of the present disclosure includes a pair of jaws for performing a grip motion, that is, the first jaw1101 and a second jaw1102. Here, each of the first jaw1101 and the second jaw1102, or a component encompassing the first jaw1101 and the second jaw1102 may be referred to as the jaw1103.

Further, the end tool1100 may include the pulley1111, a pulley1113, a pulley1114, a pulley1115, and a pulley1116 associated with a rotational motion of the first jaw1101. In addition, the end tool1100 may include the pulley1121, a pulley1123, a pulley1124, a pulley1125, and a pulley1126, which are associated with a rotational motion of the second jaw1102.

Here, the pulleys facing each other are illustrated in the drawings as being formed parallel to each other, but the concept of the present disclosure is not limited thereto, and each of the pulleys may be variously formed with a position and a size suitable for the configuration of the end tool.

Further, the end tool1100 of the fourth embodiment of the present disclosure may include the end tool hub1160 and the pitch hub1150.

A first rotation shaft1141 to be described later may be inserted through the end tool hub1160, and the pulley1111 and the pulley1121 axially coupled to the first rotation shaft1141 and at least some of the first jaw1101 and the second jaw1102 coupled to the pulley1111 and the pulley1121 may be accommodated inside the end tool hub1160. Here, in an embodiment of the present disclosure, a wire guide portion1168 serving as an auxiliary pulley is formed in the end tool hub1160. That is, a first wire guide portion1168aand a second wire guide portion1168bfor guiding paths of the wire305 and the wire302 may be formed in the end tool hub1160. The wire guide portions1168 of the end tool hub1160 may serve as auxiliary pulleys (see612 and622 ofFIG.39) of the first embodiment and change the paths of the wires, and the first wire guide portion1168aand the second wire guide portion1168bof the end tool hub1160 serving as auxiliary pulleys will be described in more detail later.

Meanwhile, the first pitch pulley portion1163aand the second pitch pulley portion1163b, which serve as end tool pitch pulleys, may be formed at one end portion of the end tool hub1160. The wire303 and the wire304, which are pitch wires, are coupled to the first pitch pulley portion1163aand the second pitch pulley portion1163b, which serve as end tool pitch pulleys, and a pitch motion is performed while the end tool hub1160 rotates around a third rotation shaft1143.

The third rotation shaft1143 and a fourth rotation shaft1144 may be inserted through the pitch hub1150, and the pitch hub1150 may be axially coupled to the end tool hub1160 by the third rotation shaft1143. Accordingly, the end tool hub1160 may be formed to be pitch-rotatable around the third rotation shaft1143 with respect to the pitch hub1150.

Further, the pitch hub1150 may internally accommodate at least some of the pulley1113, the pulley1114, the pulley1123, and the pulley1124 that are axially coupled to the third rotation shaft1143. Further, the pitch hub1150 may internally accommodate at least some of the pulley1115, the pulley1116, the pulley1125, and the pulley1126 that are axially coupled to the fourth rotation shaft1144.

One end portion of the pitch hub1150 is connected to the end tool hub1160, and the other end portion of the pitch hub1150 is connected to the connection portion400.

Here, the end tool1100 of the fourth embodiment of the present disclosure may include the first rotation shaft1141, the third rotation shaft1143, and the fourth rotation shaft1144. As described above, the first rotation shaft1141 may be inserted through the end tool hub1160, and the third rotation shaft1143 and the fourth rotation shaft1144 may be inserted through the pitch hub1150.

The first rotation shaft1141, the third rotation shaft1143, and the fourth rotation shaft1144 may be arranged sequentially from the distal end1104 toward the proximal end1105 of the end tool1100. Accordingly, starting from the distal end1104, the first rotation shaft1141 may be referred to as a first pin, the third rotation shaft1143 may be referred to as a third pin, and the fourth rotation shaft1144 may be referred to as a fourth pin.

Here, the first rotation shaft1141 may function as an end tool jaw pulley rotation shaft, the third rotation shaft1143 may function as an end tool pitch rotation shaft, and the fourth rotation shaft1144 may function as an end tool pitch auxiliary rotation shaft of the end tool1100.

Here, each of the rotation shafts may include two shafts of a first sub-shaft and a second sub-shaft. Alternatively, it may be said that each of the rotation shafts is formed by being divided into two parts.

For example, the first rotation shaft1141 may include two shafts of a first sub-shaft1141aand a second sub-shaft1141b. In addition, the third rotation shaft1143 may include two shafts of a first sub-shaft1143aand a second sub-shaft1143b. The fourth rotation shaft1144 may include two shafts of a first sub-shaft and a second sub-shaft.

Each of the rotation shafts is formed by being divided into two parts as described above to allow the guide tube1170 to be described later to pass through the end tool hub1160 and the pitch hub1150. That is, the guide tube1170 may pass between the first sub-shaft and the second sub-shaft of each of the rotation shafts. This will be described in more detail later. Here, the first sub-shaft and the second sub-shaft may be disposed on the same axis or may be disposed to be offset to a certain degree.

Meanwhile, it is illustrated in the drawings that each of the rotation shafts is formed by being divided into two parts, but the concept of the present disclosure is not limited thereto. That is, each of the rotation shafts is formed to be curved in the middle such that an escape path for the guide tube1170 is formed.

Each of the rotation shafts1141,1143, and1144 may be fitted into one or more pulleys, which will be described in detail below.

Meanwhile, the end tool1100 may further include an actuation rotation shaft1145. In detail, the first jaw1101 and the second jaw1102 may be axially coupled by the actuation rotation shaft1145, and in this state, an actuation motion may be performed while the first jaw1101 and the second jaw1102 rotate around the actuation rotation shaft1145. Here, the actuation rotation shaft1145 may be disposed closer to the distal end1104 than the first rotation shaft1141 is.

Here, in the end tool1100 of the fourth embodiment of the present disclosure, the first rotation shaft1141, which is a yaw rotation shaft, and the actuation rotation shaft1145 are provided separately rather than as the same shaft. That is, by forming the first rotation shaft1141, which is a rotation shaft of the pulley1111/pulley1121 that are jaw pulleys and a rotation shaft of a yaw motion, and the actuation rotation shaft1145, which is a rotation shaft of the second jaw1102 with respect to the first jaw1101 and a rotation shaft of an actuation motion, to be spaced apart from each other by a certain distance, a space in which the guide tube1170 and the blade wire307 accommodated therein can be gently bent may be secured. The actuation rotation shaft1145 will be described in detail later.

The pulley1111 functions as an end tool first jaw pulley, and the pulley1121 functions as an end tool second jaw pulley. The pulley1111 may also be referred to as a first jaw pulley, and the pulley1121 may also be referred to as a second jaw pulley, and these two components may collectively be referred to as end tool jaw pulleys or simply jaw pulleys.

The pulley1111 and the pulley1121, which are end tool jaw pulleys, are formed to face each other, and are formed to be rotatable independently of each other around the first rotation shaft1141 which is an end tool jaw pulley rotation shaft. In this case, the pulley1111 and pulley1121 are formed to be spaced apart by a certain distance, and a blade assembly accommodation portion may be accommodated therebetween. In addition, at least a part of a blade assembly to be described later may be disposed in the blade assembly accommodation portion. In other words, the blade assembly including the guide tube1170 may be disposed between the pulley1111 and the pulley1121.

Here, since the pulley1111 is connected to the first jaw1101, when the pulley1111 rotates around the first rotation shaft1141, the first jaw1101 may also rotate around the first rotation shaft1141 together with the pulley1111.

Meanwhile, since the pulley1121 is connected to the second jaw1102, when the pulley1121 rotates around the first rotation shaft1141, the second jaw1102 connected to the pulley1121 may rotate around the first rotation shaft1141.

In addition, a yaw motion and an actuation motion of the end tool1100 are performed in response to the rotation of the pulley1111 and the pulley1121. That is, when the pulley1111 and the pulley1121 rotate in the same direction around the first rotation shaft1141, the yaw motion is performed as the first jaw1101 and the second jaw1102 rotate with the first rotation shaft1141 as the center of rotation. Meanwhile, when the pulley1111 and the pulley1121 rotate in opposite directions around the first rotation shaft1141, the actuation motion is performed as the first jaw1101 and the second jaw1102 rotate around the actuation rotation shaft1145.

The pulley1113 and the pulley1114 function as end tool first jaw pitch main pulleys, and the pulley1123 and the pulley1124 function as end tool second jaw pitch main pulleys, and these two components may collectively be referred to as end tool jaw pitch main pulleys.

The pulley1115 and the pulley1116 function as end tool first jaw pitch sub-pulleys, and the pulley1125 and the pulley1126 function as end tool second jaw pitch sub-pulleys, and these two components collectively may be referred to as end tool jaw pitch sub-pulleys.

Hereinafter, components associated with the rotation of the pulley1111 will be described.

The pulley1113 and the pulley1114 function as end tool first jaw pitch main pulleys. That is, the pulley1113 and the pulley1114 function as main rotation pulleys for a pitch motion of the first jaw1101. Here, the wire301, which is a first jaw wire, is wound around the pulley1113, and the wire305, which is a first jaw wire, is wound around the pulley1114.

The pulley1115 and the pulley1116 function as end tool first jaw pitch sub-pulleys. That is, the pulley1115 and the pulley1116 function as sub-rotation pulleys for a pitch motion of the first jaw1101. Here, the wire301, which is a first jaw wire, is wound around the pulley1115, and the wire305, which is a first jaw wire, is wound around the pulley1116.

Here, the pulley1113 and the pulley1114 are disposed on one side of the pulley1111 to face each other. Here, the pulley1113 and the pulley1114 are formed to be rotatable independently of each other around the third rotation shaft1143 that is an end tool pitch rotation shaft. In addition, the pulley1115 and the pulley1116 are disposed on one side of the pulley1113 and one side of the pulley1114, respectively, to face each other. Here, the pulley1115 and the pulley1116 are formed to be rotatable independently of each other around the fourth rotation shaft1144 that is an end tool pitch auxiliary rotation shaft. Here, in the drawings, it is illustrated that the pulley1113, the pulley1115, the pulley1114, and the pulley1116 are all formed to be rotatable around a Y-axis direction, but the concept of the present disclosure is not limited thereto, and the rotation axes of the respective pulleys may be formed in various directions according to configurations thereof.

The wire301, which is a first jaw wire, is sequentially wound to make contact with at least portions of the pulley1115, the pulley1113, and the pulley1111. In addition, the wire305 connected to the wire301 by the fastening member323 is sequentially wound to make contact with at least portions of the pulley1111, the first wire guide portion1168aof the end tool hub1160, the pulley1114, and the pulley1116.

In other words, the wire301 and the wire305, which are the first jaw wire, are sequentially wound to make contact with at least portions of the pulley1115, the pulley1113, the pulley1111, the first wire guide portion1168aof the end tool hub1160, the pulley1114, and the pulley1116, and the wire301 and the wire305 formed to move along the above pulleys while rotating the above pulleys.

Accordingly, when the wire301 is pulled in the direction of an arrow301 ofFIG.145, the fastening member323 to which the wire301 is coupled and the pulley1111 coupled to the fastening member323 are rotated in the counterclockwise direction. On the contrary, when the wire305 is pulled in the direction of an arrow305 ofFIG.145, the fastening member323 to which the wire305 is coupled and the pulley1111 coupled to the fastening member323 are rotated in the clockwise direction in theFIG.145.

Next, components associated with the rotation of the pulley1121 will be described.

The pulley1123 and the pulley1124 function as end tool second jaw pitch main pulleys. That is, the pulley1123 and the pulley1124 function as main rotation pulleys for a pitch motion of the second jaw1102. Here, the wire306, which is a second jaw wire, is wound around the pulley1123, and the wire302, which is a second jaw wire, is wound around the pulley1124.

The pulley1125 and the pulley1126 function as end tool second jaw pitch sub-pulleys. That is, the pulley1125 and the pulley1126 function as sub-rotation pulleys for a pitch motion of the second jaw1102. Here, the wire306, which is a second jaw wire, is wound around the pulley1125, and the wire302, which is a second jaw wire, is wound around the pulley1126.

Here, the pulley1123 and the pulley1124 are disposed on one side of the pulley1121 to face each other. Here, the pulley1123 and the pulley1124 are formed to be rotatable independently of each other around the third rotation shaft1143 that is an end tool pitch rotation shaft. In addition, the pulley1125 and the pulley1126 are disposed on one side of the pulley1123 and one side of the pulley1124, respectively, to face each other. Here, the pulley1125 and the pulley1126 are formed to be rotatable independently of each other around the fourth rotation shaft1144 that is an end tool pitch auxiliary rotation shaft. Here, in the drawings, it is illustrated that all of the pulley1123, the pulley1125, the pulley1124, and the pulley1126 are formed to be rotatable around the Y-axis direction, but the concept of the present disclosure is not limited thereto, and the rotating axes of the respective pulleys may be formed in various directions according to configurations thereof.

The wire306, which is a second jaw wire, is sequentially wound to make contact with at least portions of the pulley1125, the pulley1123, and the pulley1121. In addition, the wire302 connected to the wire306 by the fastening member326 is sequentially wound to make contact with at least portions of the pulley1121, the second wire guide portion1168bof the end tool hub1160, the pulley1124, and the pulley1126.

In other words, the wire306 and the wire302, which are the second jaw wire, are sequentially wound to make contact with at least portions of the pulley1125, the pulley1123, the pulley1121, the second wire guide portion1168bof the end tool hub1160, the pulley1124, and the pulley1126, and the wire306 and the wire302 are formed to move along the above pulleys while rotating the above pulleys.

Accordingly, when the wire306 is pulled in the direction of an arrow306 ofFIG.145, the fastening member326 to which the wire306 is coupled and the pulley1121 coupled to the fastening member326 are rotated in the clockwise direction inFIG.145. On the contrary, when the wire302 is pulled toward the arrow302 ofFIG.145, the fastening member326 coupled to the wire302 and the pulley1121 coupled to the fastening member326 may rotate in the counterclockwise direction inFIG.145.

Hereinafter, a pitch motion of the present disclosure will be described in more detail.

Meanwhile, when the wire301 is pulled in the direction of the arrow301 ofFIG.145, and simultaneously, the wire305 is pulled in the direction of the arrow305 ofFIG.145 (that is, when both strands of the first jaw wire are pulled), as shown inFIG.144, since the wires301 and305 are wound around lower portions of the pulley1113 and the pulley1114 rotatable around the third rotation shaft1143, which is an end tool pitch rotation shaft, the pulley1111 to which the wires301 and305 are fixedly coupled and the end tool hub1160 to which the pulley1111 is coupled rotate as a whole in the counterclockwise direction around the third rotation shaft1143, and as a result, the end tool1100 may rotate downward to perform the pitch motion. At this time, since the second jaw1102 and the wires302 and306 fixedly coupled thereto are wound around upper portions of the pulley1123 and the pulley1124 rotatable around the third rotation shaft1143, the wires302 and306 are released in the opposite directions of the arrows302 and306, respectively.

On the contrary, when the wire302 is pulled in the direction of the arrow302 ofFIG.145, and simultaneously, the wire306 is pulled in the direction of the arrow306 ofFIG.145, as shown inFIG.144, since the wires302 and306 are wound around the upper portions of the pulley1123 and the pulley1124 rotatable around the third rotation shaft1143, which is an end tool pitch rotation shaft, the pulley1121 to which the wires302 and306 are fixedly coupled and the end tool hub1160 to which the pulley1121 is coupled rotate as a whole in the clockwise direction around the third rotation shaft1143, and as a result, the end tool1100 may rotate upward to perform the pitch motion. At this time, since the first jaw1101 and the wires301 and305 fixedly coupled thereto are wound around lower portions of the pulley1113 and the pulley1114 rotatable around the third rotation shaft1143, the wires302 and306 are moved in the opposite directions of the arrows301 and305, respectively.

Meanwhile, the end tool hub1160 of the end tool1100 of the electric cauterization surgical instrument10 of the present disclosure may further include the first pitch pulley portion1163aand the second pitch pulley portion1163bserving as end tool pitch pulleys, the manipulation portion200 may further include the pulley231 and a pulley232, which are manipulation portion pitch pulleys, and the power transmission portion300 may further include the wire303 and the wire304 which are pitch wires.

In detail, the end tool hub1160 including the first pitch pulley portion1163aand the second pitch pulley portion1163bmay be formed to be rotatable around the third rotation shaft1143 that is an end tool pitch rotation shaft. In addition, the wires303 and304 may serve to connect the first and second pitch pulley portions1163aand1163bof the end tool1100 and the pulleys231 and232 of the manipulation portion200.

Thus, when the pulleys231 and232 of the manipulation portion200 rotate, the rotation of the pulleys231 and232 is transmitted to the end tool hub1160 of the end tool1100 through the wires303 and304, causing the end tool hub1160 to rotate as well, and as a result, the end tool1100 performs a pitch motion while rotating.

That is, the electric cauterization surgical instrument10 according to the fourth embodiment of the present disclosure includes the first and second pitch pulley portions1163aand1163bof the end tool1100, the pulleys231 and232 of the manipulation portion200, and the wires303 and304 of the power transmission portion300 in order to transmit driving force for a pitch motion, and thus, the driving force for the pitch motion of the manipulation portion200 is more completely transmitted to the end tool1100, thereby improving operation reliability.

(Blade Wire and Guide Tube)

Hereinafter, the blade wire307 and the guide tube1170 of the present disclosure will be described in more detail.

The guide tube1170 according to the present disclosure is formed to surround the blade wire307 in a certain section, and at this time, the blade wire307 is movable inside the guide tube1170. In other words, in a state in which in which the blade wire307 is inserted into the guide tube1170, the blade wire307 is movable relative to the guide tube1170.

Here, the guide tube1170 serves to guide the path of the blade wire307 by preventing the blade wire307 from being curved in an unintended direction when the blade wire307 is pushed or pulled. A cutting motion may be smoothly performed by the guide tube1170.

Meanwhile, one end portion of the guide tube1170 may be fixedly coupled to an actuation hub1190 to be described later. Here, the actuation hub1190 may serve as a first coupling portion. In addition, the other end portion of the guide tube1170 may be fixedly coupled to a second coupling portion (not shown) in the connection portion400. Since both end portions of the guide tube1170 are fixedly coupled to certain points (the first coupling portion and the second coupling portion) as described above, respectively, the entire length of the guide tube1170 may remain constant. Accordingly, the length of the blade wire307 inserted into the guide tube1170 may also remain constant.

Meanwhile, the guide tube1170 according to the present disclosure may be formed of a flexible material and formed to be bendable. Accordingly, when the end tool1100 performs a yaw motion around the first rotation shaft1141 or a pitch motion around the third rotation shaft1143, the guide tube1170 may be bent while being deformed in shape corresponding thereto. In addition, when the guide tube1170 is bent, the blade wire307 placed thereinside is also bent.

Here, although the length of the guide tube1170 is constant, the relative position and distance of the first coupling portion (i.e., the actuation hub1190) and the second coupling portion (not shown) may be changed as the end tool1100 is pitch-rotated or yaw-rotated, and thus a space for the guide tube1170 to move by the changed distance is required. To this end, a pitch slit1164 and a yaw slit1165 may be provided in the end tool hub1160 to form spaces for movement of the guide tube1170. Such a configuration of the end tool hub1160 will be described in detail later.

Meanwhile, as described above, the blade wire307 is inserted through the guide tube1170, and the blade wire307 is relatively movable inside the guide tube1170 with respect to the guide tube1170. That is, when the blade wire307 is pulled in a state in which the guide tube1170 is fixed, the blade1175 connected to the blade wire307 is moved toward the proximal end1105, and when the blade wire307 is pushed, the blade1175 connected to the blade wire307 is moved toward the distal end1104.

This will be described below in more detail.

The most reliable way to perform a cutting motion using the blade1175 is by pushing and pulling the blade1175 with the blade wire307. In addition, in order for the blade wire307 to push and pull the blade1175, the guide tube1170 that can guide the path of the blade wire307 should be provided. When the guide tube1170 does not guide the path of the blade wire307 (i.e., does not hold the blade wire307), a phenomenon may occur in which cutting is not performed and a middle portion of the blade wire307 is curved even when the blade wire307 is pushed. Accordingly, in order to reliably perform the cutting motion using the blade1175, the blade wire307 and the guide tube1170 should be essentially included.

However, when the blade wire307 is used to drive a cutting motion, the cutting should be performed while pushing the blade wire307, and in this case, in order for the blade wire307 to receive a force, a relatively stiff (i.e., non-bendable) wire should be used for the blade wire307. However, the stiff (i.e., non-bendable) wire may have a small bendable range and may be permanently deformed when a force equal to or greater than a certain degree is applied.

In other words, in the case of a stiff (i.e., non-bendable) wire, there is a minimum radius of curvature that may be bent and spread without permanent deformation. In other words, when the wire or the guide tube is curved below a specific radius of curvature, both the wire and the guide tube may undergo permanent deformation while being bent, thereby restricting the capacity to perform cutting while moving backward and forward. Thus, it is necessary to keep the blade wire307 curved while having a gentle curvature.

Thus, in order to prevent the blade wire307 from being rapidly bent while passing through the pulleys, a space, in which the blade wire307 can be gently bent, is required between the jaw1103 (i.e., the actuation rotation shaft1145) and the end tool hub1160 (i.e., the first rotation shaft1141 that is a yaw shaft).

To this end, according to the present disclosure, the first rotation shaft1141, which is a yaw rotation shaft, and the actuation rotation shaft1145 are separately provided, and the first rotation shaft1141 and the actuation rotation shaft1145 are spaced apart from each other by a certain distance, thereby forming a space in which the blade wire307 and the guide tube1170 can be gently bent.

As described above, since the blade wire307 and the guide tube1170 need to be connected to the blade1175 through the end tool hub1160, and a space in which the blade wire307 and the guide tube1170 can be bent in the end tool hub1160 is necessary, in the present disclosure, 1) spaces, through which the blade wire307/the guide tube1170 can pass and simultaneously are bendable, that is, the pitch slit1164 and the yaw slit1165, are formed in the end tool hub1160,2) each of the rotation shafts is formed by being divided into two parts, and 3) a pitch round portion1166 and a yaw round portion1167 are additionally formed to guide the bending of the blade wire307 and the guide tube1170.

In other words, when one end portion of the guide tube1170 is fixed in the connection portion400, and the other end portion thereof is moved while performing pitch and yaw motions, the guide tube1170 is curved in a direction, in which the gentlest curvature (hereinafter, referred to as “maximum gentle curvature”) can be achieved in response to a change in a distance between both end portions thereof. As such, by achieving the maximum gentle curvature of the natural state, the motion of the blade wire307 is smooth and the permanent deformation does not occur.

Thus, in order to secure the maximum gentle curvature, the pitch slit1164 and the yaw slit1165 are formed on the path of the guide tube1170, and furthermore, the pitch round portion1166 and the yaw round portion1167 may be additionally formed in the end tool hub1160. Accordingly, the guide tube1170 may have such a shape that is the most similar to the maximum gentle curvature (although not having the maximum gentle curvature).

Hereinafter, the end tool hub1160 will be described in more detail.

(End Tool Hub)

FIG.147 is a perspective view illustrating the end tool hub of the surgical instrument for electrocautery ofFIG.140.FIGS.148 and149 are cut-away perspective views of the end tool hub ofFIG.147.FIGS.150 and151 are perspective views illustrating the end tool hub ofFIG.147.FIG.152 is a side view illustrating the end tool hub ofFIG.147 and the guide tube.FIG.153 is a plan view illustrating the end tool hub ofFIG.147 and the guide tube.

Referring toFIGS.147 to153, the end tool hub1160 includes a body portion1161, a first jaw pulley coupling portion1162a, a second jaw pulley coupling portion1162b, the first pitch pulley portion1163a, the second pitch pulley portion1163b, the pitch slit1164, the yaw slit1165, the pitch round portion1166, the yaw round portion1167, and the wire guide portion1168. In addition, the wire guide portion1168 includes the first wire guide portion1168aand the second wire guide portion1168b.

The first jaw pulley coupling portion1162aand the second jaw pulley coupling portion1162bmay be formed in the end tool hub1160 at the distal end side. Here, the first jaw pulley coupling portion1162aand the second jaw pulley coupling portion1162bare formed to face each other, and the pulley1111 and the pulley1121 are accommodated therein. Here, the first jaw pulley coupling portion1162aand the second jaw pulley coupling portion1162bmay be formed to be approximately parallel to a plane perpendicular to the first rotation shaft1141 that is a yaw rotation shaft.

The first jaw pulley coupling portion1162aand the second jaw pulley coupling portion1162bare connected by the body portion1161. That is, the first jaw pulley coupling portion1162aand the second jaw pulley coupling portion1162b, which are parallel to each other, are coupled by the body portion1161 formed in a direction approximately perpendicular to the first jaw pulley coupling portion1162aand the second jaw pulley coupling portion1162b, so that the first jaw pulley coupling portion1162a, the second jaw pulley coupling portion1162b, and the body portion1161 form an approximately U-shape, in which the pulley1111 and the pulley1121 are accommodated.

In other words, it may be said that the first jaw pulley coupling portion1162aand the second jaw pulley coupling portion1162bare formed to extend in the X-axis direction from the body portion1161.

Here, the pulley1111, which is a first jaw pulley, is disposed close to the first jaw pulley coupling portion1162aof the end tool hub1160, and the pulley1121, which is a second jaw pulley, is disposed close to the second jaw pulley coupling portion1162bof the end tool hub1160, and thus the yaw slit1165 may be formed between the first jaw pulley coupling portion1162aand the second jaw pulley coupling portion1162b. In addition, at least a part of the blade assembly to be described later may be disposed in the yaw slit1165. In other words, it may be said that at least a part of the guide tube1170 of the blade assembly may be disposed between the first jaw pulley coupling portion1162aand the second jaw pulley coupling portion1162b. As such, by disposing the blade assembly including the guide tube1170 between the pulley1111, which is a first jaw pulley, and the pulley1121, which is a second jaw pulley, the end tool1100 is able to perform the cutting motion using the blade1175 in addition to the pitch and yaw motions. This will be described in more detail later.

Meanwhile, a through hole is formed in the first jaw pulley coupling portion1162asuch that the first rotation shaft1141 passes through the first jaw pulley coupling portion1162aand the pulley1111 and axially couples the first jaw pulley coupling portion1162aand the pulley1111. In addition, a through hole is formed in the second jaw pulley coupling portion1162bsuch that the first rotation shaft1141 passes through the second jaw pulley coupling portion1162band the pulley1121 and axially couples the second jaw pulley coupling portion1162band the pulley1121.

Here, as described above, the first rotation shaft1141, which is a yaw rotation shaft, may be formed by being divided into two parts of the first sub-shaft1141aand the second sub-shaft1141b, and the guide tube1170 may pass between the first sub-shaft1141aand the second sub-shaft1141bof the first rotation shaft1141.

In addition, the yaw slit1165 may be formed between the first jaw pulley coupling portion1162aand the second jaw pulley coupling portion1162b. Since the yaw slit1165 is formed in the end tool hub1160 as described above, the guide tube1170 may pass through the inside of the end tool hub1160.

In other words, the first rotation shaft1141 is vertically separated into two parts without passing through the end tool hub1160, and the yaw slit1165 may be formed on a plane perpendicular to the first rotation shaft1141 in the vicinity of the first rotation shaft1141. Accordingly, the guide tube1170 is movable (i.e., movable left and right) in the yaw slit1165 while passing through the vicinity of the first rotation shaft1141.

Meanwhile, the yaw round portion1167 may be further formed in the body portion1161. The yaw round portion1167 may be formed to be rounded so as to have a predetermined curvature. In detail, when viewed from a plane perpendicular to the first rotation shaft1141 that is a yaw rotation shaft, the yaw round portion1167 may be formed to be rounded so as to have a predetermined curvature. For example, the yaw round portion1167 may be formed in a fan shape, and may be formed along a path in which the guide tube1170 is bent on an XY plane. The yaw round portion1167 as described above may serve to guide the path of the guide tube1170 when the end tool1100 yaw-rotates.

The wire guide portion1168, which guides a path of the wire passing through the inside of the end tool hub1160, is formed at one side of the body portion1161. Here, the wire guide portion1168 includes the first wire guide portion1168aand the second wire guide portion1168b. Here, the first wire guide portion1168amay be formed on an inner side surface of the first jaw pulley coupling portion1162a. In addition, the second wire guide portion1168bmay be formed on an inner side surface of the second jaw pulley coupling portion1162b.

Here, the wire guide portion1168 may be formed in a cylindrical shape with a cross section that is approximately semi-circular. In addition, the semi-circular portion may be disposed to protrude toward the pulley1111 and the pulley1121. In other words, it may be said that the wire guide portion1168 is formed to protrude toward a space formed by the first jaw pulley coupling portion1162a, the second jaw pulley coupling portion1162b, and the body portion1161. In other words, it may be said that, in the wire guide portion1168, a region adjacent to the first jaw pulley coupling portion1162aand the second jaw pulley coupling portion1162bis formed to have a cross section that is curved with a predetermined curvature.

Alternatively, in other words, it may be also said that the wire guide portion1168 functions as a kind of pulley member, which guides the paths of the wire305 and the wire302 by winding the wire305 and the wire302 around an outer circumferential surface thereof. However, here, the wire guide portion1168 is not a member that rotates around a certain shaft as the original meaning pulley does, and it may be said that the wire guide portion1168 is formed to be fixed as a portion of the end tool hub1160 and performs some similar functions of a pulley by winding a wire therearound.

Here, the wire guide portion1168 is illustrated in the drawing as being formed in a cylindrical shape with a cross section that is approximately semi-circular. That is, at least a part of the cross section of the wire guide portion1168 on the XY plane is illustrated as having a certain arc shape. However, the concept of the present disclosure is not limited thereto, and the cross section may have a predetermined curvature like an oval or a parabola, or a corner of a polygonal column is rounded to a certain degree, so that the cross section may have various shapes and sizes suitable for guiding the paths of the wire305 and the wire302.

Here, a guide groove for guiding the paths of the wire305 and the wire302 well may be further formed in a portion of the wire guide portion1168, which is in contact with the wire305 and the wire302. The guide groove may be formed in the form of a groove recessed to a certain degree from a protruding surface of the wire guide portion1168.

Here, although the guide groove is illustrated in the drawing as being formed in the entire arc surface of the wire guide portion1168, the concept of the present disclosure is not limited thereto, and the guide groove may be formed only in a portion of the arc surface of the wire guide portion1168 as necessary.

As described above, by further forming the guide groove in the wire guide portion1168, unnecessary friction between the wires is reduced, so that durability of the wires may be improved.

The first pitch pulley portion1163aand the second pitch pulley portion1163b, which serve as end tool pitch pulleys, may be formed on the end tool hub1160 at the proximal end side. Here, the first pitch pulley portion1163aand the second pitch pulley portion1163bmay be formed to face each other. Here, the first pitch pulley portion1163aand the second pitch pulley portion1163bmay be formed to be approximately parallel to a plane perpendicular to the third rotation shaft1143, which is a pitch rotation shaft.

In detail, one end portion of the end tool hub1160 is formed in a disk shape similar to a pulley, and grooves around which a wire may be wound may be formed on an outer circumferential surface of the one end portion, thereby forming the first pitch pulley portion1163aand the second pitch pulley portion1163bThe wire303 and the wire304 described above are coupled to the first pitch pulley portion1163aand the second pitch pulley portion1163b, which serve as end tool pitch pulleys, and a pitch motion is performed while the end tool hub1160 rotates around the third rotation shaft1143.

Meanwhile, although not shown in the drawings, the pitch pulley may be formed as a separate member from the end tool hub1160 and coupled to the end tool hub1160.

The first pitch pulley portion1163aand the second pitch pulley portion1163bmay be connected by the body portion1161. That is, the first pitch pulley portion1163aand the second pitch pulley portion1163b, which are parallel to each other, are coupled by the body portion1161 formed in a direction approximately perpendicular to the first pitch pulley portion1163aand the second pitch pulley portion1163b, and thus the first pitch pulley portion1163a, the second pitch pulley portion1163b, and the body portion1161 may form an approximately U-shape.

In other words, it may be said that the first pitch pulley portion1163aand the second pitch pulley portion1163bare formed to extend from the body portion1161 in the X-axis direction.

Meanwhile, a through hole is formed in the first pitch pulley portion1163aso that the third rotation shaft1143 may pass through the first pitch pulley portion1163a. In addition, a through hole is formed in the second pitch pulley portion1163bso that the third rotation shaft1143 may pass through the second pitch pulley portion1163b.

In this case, as described above, the third rotation shaft1143, which is a pitch rotation shaft, may be formed by being divided into two parts of the first sub-shaft1143aand the second sub-shaft1143b, and the guide tube1170 may pass between the first sub-shaft1143aand the second sub-shaft1143bof the third rotation shaft1143.

The pitch slit1164 may be formed between the first pitch pulley portion1163aand the second pitch pulley portion1163b. Since the pitch slit1164 is formed in the end tool hub1160 as described above, the guide tube1170 may pass through the inside of the end tool hub1160.

In other words, the third rotation shaft1143 is horizontally separated into two parts without passing through the end tool hub1160, and the pitch slit1164 may be formed on a plane perpendicular to the third rotation shaft1143 in the vicinity of the third rotation shaft1143. Accordingly, the guide tube1170 is movable (movable up and down) in the pitch slit1164 while passing through the vicinity of the third rotation shaft1143.

Meanwhile, the pitch round portion1166 may be further formed in the body portion1161. The pitch round portion1166 may be formed to be rounded to have a predetermined curvature. In detail, when viewed from a plane perpendicular to the third rotation shaft1143, which is a pitch rotation shaft, the pitch round portion1166 may be formed to be rounded to have a predetermined curvature. For example, the pitch round portion1166 may be formed in a fan shape, and formed along a path in which the guide tube1170 is bent on the XZ plane. The pitch round portion1166 as described above may serve to guide the path of the guide tube1170 when the end tool1100 pitch-rotates.

Here, the pitch slit1164 and the yaw slit1165 may be formed to be connected to each other. Accordingly, the guide tube1170 and the blade wire307 located therein may be disposed to completely pass through the inside of the end tool hub1160. In addition, the blade1175 coupled to one end portion of the blade wire307 may linearly reciprocate inside the first jaw1101 and the second jaw1102.

As described above, since the blade wire307 and the guide tube1170 need to be connected to the blade1175 through the end tool hub1160, and a space in which the blade wire307 and the guide tube1170 can be bent in the end tool hub1160 is necessary, in the present disclosure, 1) spaces, through which the blade wire307/the guide tube1170 can pass and simultaneously are bendable, that is, the pitch slit1164 and the yaw slit1165, are formed in the end tool hub1160, 2) the rotation shafts are formed by being divided into two parts, and 3) the pitch round portion1166 and the yaw round portion1167 are additionally formed to guide the bending of the blade wire307/the guide tube1170.

Hereinafter, the role and function of the wire guide portion1168 will be described in more detail.

The wire guide portion1168 may be in contact with the wire305 and the wire302 and may change the arrangement path of the wire305 and the wire302 to a certain degree to serve to increase a rotation radius of each of the first jaw1101 and the second jaw1102.

That is, when the auxiliary pulleys are not disposed, each of the pulley1111, which is a first jaw pulley, and the pulley1121, which is a second jaw pulley, may rotate up to a right angle, but in the fourth embodiment of the present disclosure, by additionally providing the wire guide portion1168 in the end tool hub1160, the maximum rotation angle of each pulley may be increased.

This enables a motion in which two jaws of the end tool1100 have to be spread apart for an actuation motion in a state in which the two jaws are yaw-rotated together by 90°. In other words, the range of yaw rotation in which an actuation motion is possible may be increased through the configuration of the wire guide portion1168 of the end tool hub1160. In other words, the range of yaw rotation in which an actuation motion is possible may be increased through the configuration of the wire guide portion1168 of the end tool hub1160. Furthermore, by forming the wire guide portion1168 in the end tool hub1160, which already exists, without adding a separate structure such as an auxiliary pulley, the range of rotation may be increased without adding a component and a manufacturing process.

As described above, since there is no need to additionally dispose a separate structure for increasing the rotation angle, the number of components is decreased and the manufacturing process is simplified, and also, the length of the end tool is shortened by as much as the size of the auxiliary pulley, so that the length of the end tool is shortened during a pitch motion. Accordingly, a surgical motion may be more easily performed in a narrow space.

This will be described below in more detail.

In the end tool1100 of the surgical instrument according to the fourth embodiment of the present disclosure, the arrangement path of the wires may be changed without a separate structure by forming the wire guide portion1168 capable of changing the path of the wire on an inner side wall of the end tool hub1160. As described above, as the arrangement path of the wire305 and the wire302 is changed to a certain degree by forming the wire guide portion1168 in the end tool hub1160, a tangential direction of the wire305 and the wire302 is changed, and accordingly, rotation angles of the fastening member323 and the fastening member326 that couple respective wires and pulleys may be increased.

That is, the fastening member326 that couples the wire302 and the pulley1121 is rotatable until being located on a common internal tangent of the pulley1121 and the wire guide portion1168. Similarly, the fastening member (see323 ofFIG.6) that couples the wire305 and the pulley1111 is rotatable until being located on a common internal tangent of the pulley1111 and the wire guide portion1168, so that a rotation angle of the fastening member (see323 ofFIG.6) may be increased.

In other words, the wire301 and the wire305 wound around the pulley1111 by the wire guide portion1168 are disposed on one side with respect to a plane perpendicular to the Y-axis and passing through the X-axis. Simultaneously, the wire302 and the wire306 wound around the pulley1121 by the wire guide portion1168 are disposed on the other side with respect to the plane perpendicular to the Y-axis and passing through the X-axis.

In other words, the pulley1113 and the pulley1114 are disposed at one side with respect to the plane perpendicular to the Y-axis and passing through the X-axis, and the pulley1123 and the pulley1124 are disposed at the other side with respect to the plane perpendicular to the Y-axis and passing through the X-axis.

In other words, the wire305 is located on the internal tangent of the pulley1111 and the wire guide portion1168, and a rotation angle of the pulley1111 is increased due to the wire guide portion1168. In addition, the wire302 is located on the internal tangent of the pulley1121 and the wire guide portion1168, and the rotation angle of the pulley1121 is increased due to the wire guide portion1168.

In the present embodiment in which an auxiliary pulley is not formed and the wire guide portion1168 capable of changing the path of a wire is formed on the inner side wall of the end tool hub1160, the length of the end tool of the surgical instrument may be shortened as compared to the surgical instrument of the first embodiment in which a separate auxiliary pulley is formed. Since the length of the end tool is shortened as described above, a surgical operator may easily manipulate a surgical instrument, and a side effect of surgery may be reduced when the surgery is performed in a narrow surgical space in the human body.

According to the present disclosure as described above, the rotation radii of the pulley1111, which is a first jaw pulley, and the pulley1121, which is a second jaw pulley, increase, so that a yaw motion range in which a normal opening/closing actuation motion and a normal cutting motion can be performed may be increased.

(Actuation Hub)

FIGS.154A and154B are a perspective view and a cut-away perspective view illustrating an actuation hub of the surgical instrument for electrocautery ofFIG.147 ofFIG.140.FIG.155 is a view illustrating a state in which the guide tube, the blade wire, and the blade are mounted on the actuation hub illustrated in the cut-away perspective view ofFIG.154.FIG.156 is an exploded perspective view illustrating the end tool of the surgical instrument for electrocautery ofFIG.140.

Referring toFIGS.154 to156, the actuation hub1190 may be formed in the form of a box having a hollow therein. In addition, the actuation hub1190 is coupled to each of the first jaw1101 and the second jaw1102. In detail, the actuation hub1190 is axially coupled to the first jaw1101 by a first actuation rotation shaft1145a. In addition, the actuation hub1190 is axially coupled to the second jaw1102 by a second actuation rotation shaft1145b. In this case, the first actuation rotation shaft1145aand the second actuation rotation shaft1145bmay be disposed on the same line in a Z-axis direction.

In addition, a tube seating portion1190amay be formed inside the actuation hub1190, and one end portion of the guide tube1170 may be fixedly coupled to the tube seating portion1190a.

Meanwhile, a blade accommodation portion1190bmay be formed inside the actuation hub1190, and the blade1175 may be accommodated in the blade accommodation portion1190b.

In addition, a wire through-hole1190cmay be formed between the tube seating portion1190aand the blade accommodation portion1190binside the actuation hub1190.

That is, the tube seating portion1190a, the wire through-hole1190c, and the blade accommodation portion1190bare sequentially formed inside the actuation hub1190, and the blade wire307 may pass through the inside of the actuation hub1190 to be connected to the blade1175.

As described above, by providing the actuation hub1190 to which the guide tube1170 is coupled between the first jaw1101 and the second jaw1102, the guide tube1170 may not be curved, or the angle at which the guide tube1170 is curved may be reduced, even when the first jaw1101 or the second jaw1102 rotates around the first rotation shaft1141 or the actuation rotation shaft1145.

In detail, in a case in which the guide tube1170 is directly coupled to the first jaw1101 or the second jaw1102, when the first jaw1101 or the second jaw1102 rotates, one end portion of the guide tube1170 also rotates together with the first jaw1101 or the second jaw1102, causing the guide tube1170 to be curved.

On the other hand, in a case in which the guide tube1170 is coupled to the actuation hub1190, which is independent of the rotation of the jaw1103, as in the present embodiment, even when the first jaw1101 or the second jaw1102 rotates, the guide tube1170 may not be curved, or the angle at which the guide tube1170 is curved may be reduced even when the guide tube1170 is curved.

That is, by changing the direct connection between the guide tube1170 and the jaw1103 by the actuation hub1190 to an indirect connection, the degree to which the guide tube1170 is curved by the rotation of the jaw1103 may be reduced.

(First and Second Jaws and Actuation Motion)

Hereinafter, a coupling structure of the first jaw1101 and the second jaw1102 of the end tool1100 of the surgical instrument10 ofFIG.140 will be described in more detail.

Referring toFIGS.157 to162 and the like, the first jaw1101 includes a movable coupling hole1101c, a jaw pulley coupling hole1101d, and a shaft pass-through portion1101c.

The first jaw1101 is formed entirely in an elongated bar shape, and formed to be rotatable together with the pulley1111 by being coupled to the pulley1111 at one end portion thereof.

Meanwhile, the movable coupling hole1101c, the jaw pulley coupling hole1101d, and the shaft pass-through portion1101emay be formed in the first jaw1101 at a side coupled to the pulley1111, that is, at the proximal end side.

Here, the movable coupling hole1101cmay be formed to have a predetermined curvature, and may be formed in an approximately elliptical shape. A shaft coupling portion1111aof the pulley1111, which will be described later, may be fitted into the movable coupling hole1101c. Here, a short radius of the movable coupling hole1101cmay be formed to be substantially the same as or slightly greater than a radius of the shaft coupling portion1111a. Meanwhile, a long radius of the movable coupling hole1101cmay be formed to be greater than the radius of the shaft coupling portion1111a. Thus, in a state in which the shaft coupling portion1111aof the pulley1111 is fitted into the movable coupling hole1101cof the first jaw1101, the shaft coupling portion1111ais movable to a certain degree in the movable coupling hole1101c. This will be described in more detail below.

Meanwhile, the jaw pulley coupling hole1101dis formed in the form of a cylindrical hole, and a jaw coupling portion1111bof the pulley1111, which will be described later, may be fitted into the jaw pulley coupling hole1101d. Here, a radius of the jaw pulley coupling hole1101dmay be formed to be substantially the same as or slightly greater than a radius of the jaw coupling portion1111b. Thus, the jaw coupling portion1111bof the pulley1111 may be formed to be rotatably coupled to the jaw pulley coupling hole1101dof the first jaw1101. This will be described in more detail below.

Meanwhile, the shaft pass-through portion1101emay be formed in the first jaw1101 at the distal end side relative to the movable coupling hole1101cand the jaw pulley coupling hole1101d. The shaft pass-through portion1101emay be formed in the form of a hole, and the actuation rotation shaft1145, which is a jaw rotation shaft, may be inserted through the shaft pass-through portion1101e.

The second jaw1102 includes a movable coupling hole1102c, a jaw pulley coupling hole1102d, and a shaft pass-through portion1102c.

The second jaw1102 is formed entirely in an elongated bar shape, and formed to be rotatable together with the pulley1121 by being coupled to the pulley1121 at one end portion thereof.

Meanwhile, the movable coupling hole1102c, the jaw pulley coupling hole1102d, and the shaft pass-through portion1102emay be formed in the second jaw1102 at a side coupled to the pulley1111, that is, at the proximal end side.

Here, the movable coupling hole1102cmay be formed to have a predetermined curvature, and may be formed in an approximately elliptical shape. A shaft coupling portion1121aof the pulley1121, which will be described later, may be fitted into the movable coupling hole1102c. Here, a short radius of the movable coupling hole1102cmay be formed to be substantially the same as or slightly greater than a radius of the shaft coupling portion1121a. Meanwhile, a long radius of the movable coupling hole1102cmay be formed to be greater than the radius of the shaft coupling portion1121a. Thus, in a state in which the shaft coupling portion1121aof the pulley1121 is fitted into the movable coupling hole1102cof the second jaw1102, the shaft coupling portion1121ais movable to a certain degree in the movable coupling hole1102c. This will be described in more detail below.

Meanwhile, the jaw pulley coupling hole1102dis formed in the form of a cylindrical hole, and a jaw coupling portion1121bof the pulley1121, which will be described later, may be fitted into the jaw pulley coupling hole1102d. Here, a radius of the jaw pulley coupling hole1102dmay be formed to be substantially the same as or slightly greater than a radius of the jaw coupling portion1121b. Thus, the jaw coupling portion1121bof the pulley1121 may be formed to be rotatably coupled to the jaw pulley coupling hole1102dof the second jaw1102. This will be described in more detail below.

Meanwhile, the shaft pass-through portion1102emay be formed in the second jaw1102 at the distal end side relative to the movable coupling hole1102cand the jaw pulley coupling hole1102d. The shaft pass-through portion1102emay be formed in the form of a hole, and the actuation rotation shaft1145, which is a jaw rotation shaft, may be inserted through the shaft pass-through portion1102c.

The pulley1111, which is a first jaw pulley, may include the shaft coupling portion1111aand the jaw coupling portion1111b. The pulley1111 is formed entirely in the form of a rotatable disk, and the shaft coupling portion1111aand the jaw coupling portion1111bmay be formed to protrude to a certain degree from one surface of the pulley1111. As described above, the shaft coupling portion1111aof the pulley1111 may be fitted into the movable coupling hole1101cof the first jaw1101, and the jaw coupling portion1111bof the pulley1111 may be fitted into the jaw pulley coupling hole1101dof the first jaw1101. The pulley1111 may be formed to be rotatable with the first rotation shaft1141, which is an end tool jaw pulley rotation shaft, as the center of rotation.

Meanwhile, the pulley1121, which is a second jaw pulley, may include the shaft coupling portion1121aand the jaw coupling portion1121b. The pulley1121 is formed entirely in the form of a rotatable disk, and the shaft coupling portion1121aand the jaw coupling portion1121bmay be formed to protrude to a certain degree from one surface of the pulley1121. As described above, the shaft coupling portion1112aof the pulley1112 may be inserted into the movable coupling hole1102cof the second jaw1102, and the jaw coupling portion1112bof the pulley1112 may be inserted into the jaw pulley coupling hole1102dof the second jaw1102. The pulley1121 may be formed to be rotatable with the first rotation shaft1141, which is an end tool jaw pulley rotation shaft, as the center of rotation.

The coupling relationship between the components described above is as follows.

The first rotation shaft1141, which is an end tool jaw pulley rotation shaft, is sequentially inserted through the shaft coupling portion1111aof the pulley1111, the movable coupling hole1101cof the first jaw1101, the movable coupling hole1102cof the second jaw1102, and the shaft coupling portion1121aof the pulley1121.

The first actuation rotation shaft1145ais sequentially inserted through the shaft pass-through portion1101eof the first jaw1101 and the actuation hub1190 The second actuation rotation shaft1145bis sequentially inserted through the shaft pass-through portion1102eof the second jaw1102 and the actuation hub1190.

The shaft coupling portion1111aof the pulley1111 is fitted into the movable coupling hole1101cof the first jaw1101, and the jaw coupling portion1111bof the pulley1111 is fitted into the jaw pulley coupling hole1101dof the first jaw1101.

At this time, the jaw pulley coupling hole1101dof the first jaw1101 and the jaw coupling portion1111bof the pulley1111 are axially coupled to each other so as to be rotatable, and the movable coupling hole1101cof the first jaw1101 and the shaft coupling portion1111aof the pulley1111 are movably coupled to each other (here, “movably coupled” means that the shaft coupling portion1111aof the pulley1111 is coupled so as to be movable to a certain degree in the movable coupling hole1101cof the first jaw1101).

The shaft coupling portion1121aof the pulley1121 is fitted into the movable coupling hole1102cof the second jaw1102, and the jaw coupling portion1121bof the pulley1121 is fitted into the jaw pulley coupling hole1102dof the second jaw1102.

At this time, the jaw pulley coupling hole1102dof the second jaw1101 and the jaw coupling portion1121bof the pulley1121 are axially coupled to each other to be rotatable, and the movable coupling hole1102cof the second jaw1102 and the shaft coupling portion1121aof the pulley1121 are movably coupled to each other.

Here, the pulley1111 and the pulley1121 rotate around the first rotation shaft1141, which is an end tool jaw pulley rotation shaft. Meanwhile, the first jaw1101 and the second jaw1102 rotate around the actuation rotation shaft1145, which is a jaw rotation shaft. That is, the pulley1111 and the first jaw1101 have different shafts of rotation. Similarly, the pulley1121 and the second jaw1102 have different shafts of rotation.

That is, the rotation angle of the first jaw1101 is limited to a certain degree by the movable coupling hole1101c, but the first jaw1101 essentially rotates around the actuation rotation shaft1145, which is a jaw rotation shaft. Similarly, the rotation angle of the second jaw1102 is limited to a certain degree by the movable coupling hole1102c, but the second jaw1102 essentially rotates around the actuation rotation shaft1145, which is a jaw rotation shaft.

Amplification of a grip force due to the coupling relationship between the above-described components will be described.

In the surgical instrument110 according to an embodiment of the present disclosure, the coupling structure of the first jaw1101 and the second jaw1102 forms an X-shaped structure, and thus, when the first jaw1101 and the second jaw1102 rotate in a direction of approaching each other (i.e., when the first jaw1101 and the second jaw1102 are closed), the grip force is greater in a direction in which the first jaw1101 and the second jaw1102 are closed. This will be described below in more detail.

As described above, in motions of the first jaw1101 and the second jaw1102 being opened and closed, there are two shafts that serve as the centers of rotation for the first jaw1101 and the second jaw1102. That is, the first jaw1101 and the second jaw1102 perform the opening and closing motion around two shafts including the first rotation shaft1141 and the actuation rotation shaft1145. At this time, the centers of rotation of the first jaw1101 and the second jaw1102 become the actuation rotation shaft1145, and the centers of rotation of rotation of the pulley1111 and the pulley1121 become the first rotation shaft1141. At this time, the first rotation shaft1141 is a shaft whose position is relatively fixed, and the actuation rotation shaft1145 is a shaft whose position is relatively moved linearly. In other words, when the pulley1111 and the pulley1121 rotate in a state in which the position of the first rotation shaft1141 is fixed, the first jaw1101 and the second jaw1102 are opened/closed while the actuation rotation shaft1145, which is a rotation shaft of the first jaw1101 and the second jaw1102, is moved backward and forward. This will be described below in more detail.

InFIG.161, r1 is a distance from the jaw coupling portion1121bof the pulley1121 to the shaft coupling portion1121a, and a length thereof is constant. Thus, a distance from the first rotation shaft1141 inserted into the shaft coupling portion1121ato the jaw coupling portion1121bis also constant as r1.

Meanwhile, r2 ofFIG.161 is a distance from the jaw pulley coupling hole1102dof the second jaw1102 to the shaft pass-through portion1102e, and a length thereof is constant. Thus, a distance from the jaw coupling portion1121bof the pulley1121 inserted into the jaw pulley coupling hole1102dto the rotation shaft1145 inserted into the shaft pass-through portion1102eis also constant as r2.

That is, the lengths of r1 and r2 remain constant. Accordingly, when the pulley1111 and the pulley1121 rotate in the directions of an arrow B1 ofFIG.160 and an arrow B2 ofFIG.161, respectively, around the first rotation shaft1141 to perform a closing motion, the first jaw1101 and the second jaw1102 rotate around the actuation rotation shaft1145 as the angle between r1 and r2 changes while the lengths of r1 and r2 remain constant, and at this time, the actuation rotation shaft1145 itself is also linearly moved (i.e., is moved forward/backward) by as much as an arrow C1 ofFIG.160 and an arrow C2 ofFIG.161.

That is, assuming that the position of the first rotation shaft1141, which is an end tool jaw pulley rotation shaft, is fixed, when the first jaw1101 and the second jaw1102 are closed, a force is applied in a direction in which the actuation rotation shaft1145, which is a jaw rotation shaft, is moved forward (i.e., toward the distal end), and thus the grip force in the direction in which the first jaw1101 and the second jaw1102 are closed becomes larger.

In other words, since the lengths of r1 and r2 remain constant when the second jaw1102 rotates around the actuation rotation shaft1145, when the pulley1121 rotates around the first rotation shaft1141, the angle between r1 and r2 changes while the lengths of r1 and r2 remain constant. That is,02, which is the angle between r1 and r2 in a state in which the second jaw1102 is open as shown inFIG.161A, is greater than 01, which is the angle between r1 and r2 in a state in which the second jaw1102 is closed as shown inFIG.161B.

Thus, when the second jaw1102 rotates from the open state to the close state, the angle between r1 and r2 changes, and a force is applied in a direction in which the actuation rotation shaft1145 is moved forward.

In this case, since the first rotation shaft1141 is a shaft whose position is relatively fixed, the actuation rotation shaft1145 is moved forward in the direction of the arrow C1 ofFIG.160 and the direction of the arrow C2 ofFIG.161, and the grip force is further increased in a direction in which the second jaw1102 is closed.

In other words, when the pulley1111 and the pulley1121 rotate around the first rotation shaft1141, which is a shaft whose relative position is fixed, the angle θ between r1 and r2 changes while the distance between r1 and r2 remains constant. In addition, when the angle θ changes as described above, the first jaw1101 and the second jaw1102 push or pull the actuation rotation shaft1145, and thus the actuation rotation shaft1145 is moved forward or backward. In this case, when the first jaw1101 and the second jaw1102 are rotated in the direction of closing, the grip force is further increased as the actuation rotation shaft1145 is moved forward in the directions of the arrow C1 ofFIG.160 and the arrow C2 ofFIG.161. On the contrary, when the first jaw1101 and the second jaw1102 are rotated in the direction of opening, the actuation rotation shaft1145 is moved backward in directions opposite to the arrow C1 ofFIG.160 and the arrow C2 ofFIG.161.

With this configuration, the grip force becomes stronger when the first jaw1101 and the second jaw1102 are closed, thereby enabling a surgical operator to perform the actuation motion powerfully even with a small force.

(Components Associated with Cautery and Cutting)

Subsequently, referring toFIGS.140 to162 and the like, the end tool1100 of the fourth embodiment of the present disclosure may include the first jaw1101, the second jaw1102, a first electrode1151, a second electrode1152, the guide tube1170, and the blade1175 in order to perform cauterizing and cutting motions.

Here, components related to the driving of the blade, such as the guide tube1170 and the blade1175, may be collectively referred to as a blade assembly. In an embodiment of the present disclosure, by disposing the blade assembly including the guide tube1170 and the blade1175 between the pulley1111, which is a first jaw pulley, and the pulley1121, which a second jaw pulley, the end tool1100 is able to perform the cutting motion using the blade1175 in addition to the pitch and yaw motions. This will be described in more detail.

As described above, the first jaw1101 is connected to the first jaw pulley1111 and rotates around the first rotation shaft1141 together with the first jaw pulley1111 when the first jaw pulley1111 rotates around the first rotation shaft1141.

Meanwhile, the first electrode1151 may be formed on a surface of the first jaw1101 facing the second jaw1102. In addition, the second electrode1152 may be formed on a surface of the second jaw1102 facing the first jaw1101.

At this time, a slit1151amay be formed in the first electrode1151, and the blade1175 may move along the slit1151a. In addition, a slit1152amay be formed in the second electrode1152, and the blade1175 may move along the slit1152a.

Meanwhile, although not shown in the drawings, a spacer (not shown) may be formed between the first jaw1101 and the first electrode1151, and a spacer (not shown) may be formed between the second jaw1102 and the second electrode1152. The spacer (not shown) may include an insulating material such as ceramic. Alternatively, the first jaw1101 and the second jaw1102 may themselves be made of a nonconductor such that the first electrode1151 and the second electrode1152 may be maintained to be insulated from each other without a separate insulator until the first electrode1151 and the second electrode1152 are in contact with each other.

Meanwhile, although not shown in the drawings, one or more sensors (not shown) may be further formed on at least one of the first jaw1101 or the second jaw1102. The sensor (not shown) may be formed to measure at least some of current, voltage, resistance, impedance, and temperature during the cautery by locating tissue between the first jaw1101 and the second jaw1102 and passing a current through the first electrode1151 and the second electrode1152.

Alternatively, instead of providing a separate sensor, monitoring and controlling of at least some of current, voltage, resistance, impedance, and temperature may be directly performed by a generator (not illustrated) which supplies power to the electrodes.

An edge portion formed sharply and configured to cut tissue may be formed in one region of the blade1175. The tissue disposed between the first jaw1101 and the second jaw1102 may be cut as at least a part of the blade1175 moves between the distal end1104 and the proximal end1105 of the end tool1100.

Here, the guide tube1170 and the blade1175 disposed between the pulley1111 and the pulley1121 are provided in the end tool1100 of the electric cauterization surgical instrument10 according to an embodiment of the present disclosure. In addition, by providing the guide tube1170 and the blade1175, a multi-joint/multi-degree-of-freedom surgical instrument capable of pitch/yaw/actuation motions may also perform cauterizing and cutting motions. This will be described below in more detail.

So far, various types of surgical instruments for electrocautery have been developed. Among the various types of surgical instruments for electrocautery, a blood vessel resection device called “Advanced Energy Device” or “Vessel Sealer” has a sensing function added to the existing bipolar cautery method, so that power of different polarities may be supplied to two electrodes, and after denaturing a vessel with the heat generated therefrom for hemostasis, the stanched part may be cut with a blade. At this time, the impedance of the tissue (or blood vessel) while the current is flowing is measured to determine whether the cauterization is completed, and when the cauterization is completed, the current supply is automatically stopped, and the tissue is cut with the blade.

In the case of such a bipolar-type blood vessel resection device, it is essential to have a blade to cut the tissue after cauterization, and the end tool needs to be equipped with a mechanism for facilitating a linear motion of the blade, and thus joint movements such as pitch/yaw movements are not possible in most cases.

Meanwhile, there have been attempts to implement joint movements using fexible joints with multiple nodes connected in the bipolar-type blood vessel resection device, but in this case, a rotation angle is limited and it is difficult to achieve accurate motion control of the end tool.

On the other hand, in the case of a method that utilizes vibration of ultrasonic waves to perform hemostasis and cutting, it is not feasible to provide joints due to the physical properties of ultrasonic waves.

To address these problems, the end tool1100 of the electric cauterization surgical instrument10 according to an embodiment of the present disclosure includes the guide tube1170 disposed between the pulley1111 and the pulley1121, and the blade1175 that moves between a first position and a second position in response to the movement of the blade wire307 disposed inside the guide tube1170. In addition, by providing the guide tube1170 and the blade1175 as described above, pitch/yaw/actuation motions may also be performed using a pulley/wire in a bipolar-type surgical instrument for cauterizing and cutting tissue.

FIG.163 is a view illustrating a state in which the end tool of the surgical instrument for electrocautery ofFIG.140 is closed, andFIG.164 is a view illustrating a state in which the end tool of the surgical instrument for electrocautery ofFIG.140 is opened. In addition,FIG.165 is a view illustrating a state in which the blade wire307 and the blade1175 are located at a first position,FIG.166 is a view illustrating a state in which the blade wire307 and the blade1175 are located at a second position, andFIG.167 is a view illustrating a state in which the blade wire307 and the blade1175 are located at a third position.

Referring toFIGS.163 to167, it may be said that the tissue between the first jaw1101 and the second jaw1102 is cut as the cutting motion ofFIGS.165 to167 is performed in a state in which the first jaw1101 and the second jaw1102 are closed as shown inFIG.163.

Here, the first position illustrated inFIG.165 may be defined as a state in which the blade1175 is drawn in toward the proximal end1105 of the end tool1100 as much as possible. Alternatively, the first position may be defined as a state in which the blade1175 is located adjacent to the pulley1111/pulley1121.

Meanwhile, the third position illustrated inFIG.167 may be defined as a state in which the blade1175 is withdrawn toward the distal end1104 of the end tool1100 as much as possible. Alternatively, the third position may be defined as a state in which the blade1175 is spaced away from the pulley1111/pulley1121 as much as possible.

First, as shown inFIG.164, a tissue to be cut is located between the first jaw1101 and the second jaw1102 in a state in which the first jaw1101 and the second jaw1102 are opened, and then an actuation motion is performed to close the first jaw1101 and the second jaw1102 as shown inFIG.163.

Next, as shown inFIG.165, in a state in which the blade wire307 and the blade1175 are located at the first position, currents of different polarities are applied to the first electrode1151 and the second electrode1152 to cauterize the tissue between the first jaw1101 and the second jaw1102. At this time, a generator (not shown) configured to supply power to the electrodes may itself perform monitoring of at least some of current, voltage, resistance, impedance, and temperature, and may stop supplying power when the cauterization is completed.

In the state in which the cautery is completed as described above, when the blade wire307 moves sequentially in the directions of an arrow A1 ofFIG.155 and an arrow A2 ofFIG.167, the blade1175 coupled to the blade wire307 moves from the first position at the proximal end1105 of the end tool1100 toward the third position at the distal end1104 of the end tool1100, reaching the positions inFIGS.166 and167 in turn.

As such, the blade1175 cuts the tissue between the first jaw1101 and the second jaw1102 while moving in the X-axis direction.

However, it is to be understood that the linear motion of the blade1175 here does not mean a motion in a completely straight line, but rather means a motion of the blade1175 to the extent that the blade1175 is able to cut the tissue while achieving a linear motion when viewed as a whole, even though the motion is not in a completely straight line, for example, the middle part of the straight line is bent by a certain angle or there is a section having a gentle curvature in a certain section.

Meanwhile, in this state, when the blade wire307 is pulled in the opposite direction, the blade1175 coupled to the blade wire307 also returns to the first position.

According to the present disclosure, the multi-joint/multi-degree-of-freedom surgical instrument capable of pitch/yaw/actuation motions may also perform cauterizing and cutting motions.

(Manipulation Portion)

FIGS.216 and217 are perspective views illustrating the manipulation portion200 of the surgical instrument ofFIG.140.FIG.218 is a diagram schematically illustrating only the pulleys and the wires constituting the joint of the surgical instrument for electrocautery ofFIG.140.

With reference toFIGS.140 to162 andFIGS.216 to218, the manipulation portion200 of the electric cauterization surgical instrument10 according to the fourth embodiment may include the first handle204 which a user may hold, the actuation manipulation portion203 configured to control the actuation motion of the end tool1100, the yaw manipulation portion202 configured to control the yaw motion of the end tool1100, and the pitch manipulation portion201 configured to control the pitch motion of the end tool1100.FIGS.216 and217 illustrate components only associated with the pitch/yaw/actuation motions of the electric cauterization surgical instrument10.

In addition, the manipulation portion200 of the electric cauterization surgical instrument10 may further include a blade manipulation portion260 performing cutting by controlling the movement of the blade171 of the end tool1100, and a cautery manipulation portion270 performing cautery by supplying electrical energy to the first electrode1151 and the second electrode1152 of the end tool1100.

The manipulation portion200 may include a pulley210, a pulley211, a pulley212, a pulley213, a pulley214, a pulley215, a pulley216, a pulley217, and a pulley218, which are associated with the rotational motion of the first jaw1101. In addition, the manipulation portion200 may include a pulley220, a pulley221, a pulley222, a pulley223, a pulley224, a pulley225, a pulley226, a pulley227, and a pulley228, which are associated with the rotational motion of the second jaw1102. In one embodiment, the manipulation portion200 may include a pulley231, a pulley232, a pulley233, and a pulley234, which are associated with the pitch motion. The manipulation portion200 may include a pulley235 which is an intermediate pulley arranged in some positions of the bent portion402 of the connection portion400.

Here, the drawings illustrate that the pulleys facing each other are arranged in parallel with each other; however, the technical concepts of the present disclosure are not limited thereto, and each pulley may be formed in various positions and sizes suitable for the configuration of the manipulation portion200.

In addition, the manipulation portion200 of the fourth embodiment may include a rotation shaft241, a rotation shaft242, a rotation shaft243, a rotation shaft244, a rotation shaft245, and a rotation shaft246. Here, the rotation shaft241 may function as a manipulation portion first jaw actuation rotation shaft, and the rotation shaft242 may function as a manipulation portion second jaw actuation rotation shaft. In addition, the rotation shaft243 may function as a manipulation portion yaw main rotation shaft, and the rotation shaft244 may function as a manipulation portion yaw subsidiary rotation shaft. The rotation shaft245 may function as a manipulation portion pitch subsidiary rotation shaft, and the rotation shaft246 may function as a manipulation portion pitch main rotation shaft.

The rotation shaft241, the rotation shaft242, the rotation shaft243, the rotation shaft244, the rotation shaft245, and the rotation shaft246 may be sequentially arranged in a direction towards a proximal end206 from a distal end205.

One or more pulleys may be fit into each of the rotation shafts241,242,243,244,245, and246 which will be described in detail below.

The pulley210 may function as a manipulation portion first jaw actuation pulley, the pulley220 may function as a manipulation portion second jaw actuation pulley, and these components may be collectively referred to as a manipulation portion actuation pulley.

The pulley211 and the pulley212 may function as a manipulation portion first jaw yaw main pulley, the pulley221 and the pulley222 may function as a manipulation portion second jaw yaw main pulley, and these two components may collectively be referred to as a manipulation portion yaw main pulley.

The pulley213 and the pulley214 may function as a manipulation portion first jaw yaw subsidiary pulley, the pulley223 and the pulley224 may function as a manipulation portion second jaw yaw subsidiary pulley, and these two components may collectively be referred to as a manipulation portion yaw subsidiary pulley.

The pulley215 and the pulley216 may function as a manipulation portion first jaw pitch subsidiary pulley, the pulley225 and the pulley226 may function as a manipulation portion second jaw pitch subsidiary pulley, and these two components may collectively be referred to as a manipulation portion pitch subsidiary pulley.

The pulley217 and the pulley218 may function as a manipulation portion first jaw pitch main pulley, the pulley227 and the pulley228 may function as a manipulation portion second jaw pitch main pulley, and these two components may collectively be referred to as a manipulation portion pitch main pulley.

The pulley231 and the pulley232 may function as a manipulation portion pitch wire main pulley, and the pulley233 and the pulley234 may function as a manipulation portion pitch wire subsidiary pulley.

The components may be classified from the viewpoint of the manipulation portion in connection with each motion (i.e., pitch/yaw/actuation) as follows.

The pitch manipulation portion201 controlling the pitch motion of the end tool1100 may include a pulley215, a pulley216, a pulley217, a pulley218, a pulley225, a pulley226, and a pulley227, a pulley228, a pulley231, a pulley232, and a pulley234. In addition, the pitch manipulation portion201 may include the rotation shaft245 and the rotation shaft246. In one embodiment, the pitch manipulation portion201 may further include a pitch frame208.

The yaw manipulation portion202 controlling the yaw motion of the end tool1100 may include a pulley211, a pulley212, a pulley213, a pulley214, a pulley221, a pulley222, a pulley223, and a pulley224. In addition, the yaw manipulation portion202 may include the rotation shaft243 and the rotation shaft244. In one embodiment, the yaw manipulation portion202 may further include a yaw frame207.

The actuation manipulation portion203 controlling the actuation motion of the end tool1100 may include the pulley210, the pulley220, the rotation shaft241, and the rotation shaft242. In one embodiment, the actuation manipulation portion203 may further include a first actuation manipulation portion251 and a second actuation manipulation portion256.

Hereinafter, each component of the manipulation portion200 will be described in more detail.

The first handle204 may be held by a user, and more particularly, a user may hold the first handle204 by wrapping it with his or her hand. The actuation manipulation portion203 and the yaw manipulation portion202 may be formed on the first handle204, and the pitch manipulation portion201 may be formed on one side of the yaw manipulation portion202. In addition, another end of the pitch manipulation portion201 may be connected to the bent portion402 of the connection portion400.

The actuation manipulation portion203 may include the first actuation manipulation portion251 and the second actuation manipulation portion256. The first actuation manipulation portion251 may include the rotation shaft241, the pulley210, a first actuation extension portion252, and a first actuation gear253. The second actuation manipulation portion256 may include the rotation shaft242, the pulley220, a second actuation extension portion257, and a second actuation gear258. Here, ends of the first actuation extension portion252 and the second actuation extension portion257 may be formed in the shape of a hand ring, and may operate as a second handle.

The rotation shaft241 and the rotation shaft242, which are the actuation rotation shaft, may be formed to have a certain angle with the XY plane on which the connection portion400 is formed. For example, the rotation shaft241 and the rotation shaft242 may be formed in a direction parallel with the Z-axis, and when the pitch manipulation portion201 or the yaw manipulation portion203 rotates, a coordinate system of the actuation manipulation portion203 may be changed relatively. However, the technical ides of the present disclosure are not limited thereto, and by an ergonomic design, the rotation shaft241 and the rotation shaft242 may be formed in various directions suitable for a hand structure of a user holding the actuation manipulation portion203.

The pulley210, the first actuation extension portion252, and the first actuation gear253 may be fixedly coupled to each other and rotatable together around the rotation shaft241. Here, the pulley210 may include one pulley or two pulleys fixedly coupled to each other.

Likewise, the pulley220, the second actuation extension portion257, and the second actuation gear258 may be fixedly coupled to each other and rotatable together around the rotation shaft242. Here, the pulley220 may include one pulley or two pulleys fixedly coupled to each other.

The first actuation gear253 and the second actuation gear258 may be formed to engage with each other, and when either one of them rotates in one direction, the other one may rotate concurrently in the opposite direction.

The yaw manipulation portion202 may include the rotation shaft243, the pulley211 and the pulley212, which are the manipulation portion first jaw yaw main pulley, the pulley211 and the pulley212, which are the manipulation portion second jaw yaw main pulley, and the yaw frame207. In addition, the yaw manipulation portion202 may further include the pulley213 and the pulley214, which are the manipulation portion first jaw yaw subsidiary pulley and arranged on one side of the pulley211 and the pulley212, and the pulley223 and the pulley224, which are the manipulation portion second jaw yaw subsidiary pulley and arranged on one side of the pulley221 and the pulley222. Here, the pulley213, the pulley214, the pulley223, and the pulley224 may be coupled to the pitch frame208 to be described later.

The drawings illustrate that the yaw manipulation portion202 includes the pulley211, the pulley212, the pulley221, and the pulley222, and as the pulley211 faces the pulley212 and the pulley221 faces the pulley222, two pulleys may be rotatable independently of each other; however the technical concepts of the present disclosure are not limited thereto. That is, one or more pulleys having the same diameter or different diameters may be provided according to the configuration of the yaw manipulation portion202.

More specifically, on the first handle204, the rotation shaft243, which is the manipulation portion yaw main rotation shaft, may be formed on one side of the actuation manipulation portion203. In this case, the first handle204 may be formed to be rotatable around the rotation shaft243.

Here, the rotation shaft243 may be formed to have a certain angle with the XY plane on which the connection portion400 is formed. For example, the rotation shaft243 may be formed in a direction parallel with the Z-axis, and when the pitch manipulation portion201 rotates, the coordinate system of the rotation shaft243 may be changed relatively as described above. However, the technical ides of the present disclosure are not limited thereto, and by an ergonomic design, the rotation shaft243 may be formed in various directions suitable for a hand structure of a user holding the manipulation portion200.

The pulley211, the pulley212, the pulley221, and the pulley222 may be coupled to the rotation shaft243 to be rotatable around the rotation shaft243. In addition, the wire301 or the wire305, which is the first jaw wire, may be wound around the pulley211 and the pulley212, and the wire302 or the wire306, which is the second jaw wire, may be wound around the pulley221 and the pulley222. At this time, as the pulley211 faces the pulley212, and the pulley221 faces the pulley222, there may be two pulleys which are rotatable independently. Accordingly, as the wire wound inward and the wire wound outward may be respectively wound around separate pulleys, the pulleys may operate without interfering with each other.

The yaw frame207 may rigidly connect the first handle204, the rotation shaft241, the rotation shaft242, and the rotation shaft243, and accordingly, the first handle204, the yaw manipulation portion202, and the actuation manipulation portion203 may yaw-rotate around the rotation shaft243 in an integrated manner.

The pitch manipulation portion201 may include the rotation shaft246, the pulley217 and the pulley218, which are the manipulation portion first jaw pitch main pulley, the pulley227 and the pulley228, which are the manipulation portion second jaw pitch main pulley, and the pitch frame208. In addition, the pitch manipulation portion201 may further include the rotation shaft245, the pulley215 and the pulley216, which are the manipulation portion first jaw pitch subsidiary pulley and arranged on one side of the pulley217 and the pulley218, and the pulley225 and the pulley226, which are the manipulation portion second jaw pitch subsidiary pulley and arranged on one side of the pulley227 and pulley228. The pitch manipulation portion201 may be connected to the bent portion402 of the connection portion400 through the rotation shaft246.

More specifically, the pitch frame208 may be a base frame of the pitch manipulation portion201, and one end of the pitch frame208 may be rotatably coupled to the rotation shaft243. That is, the yaw frame207 may be formed to be rotatable around the rotation shaft243 with respect to the pitch frame208.

As described above, the yaw frame207 may connect the first handle204, the rotation shaft243, the rotation shaft241, and the rotation shaft242, and as the yaw frame207 is axially coupled to the pitch frame208, when the pitch frame208 pitch-rotates around the rotation shaft246, the yaw frame207, the first handle204, the rotation shaft241, the rotation shaft242, and the rotation shaft243, which are connected to the pitch frame208, may also pitch rotate. That is, when the pitch manipulation portion201 rotates around the rotation shaft246, the actuation manipulation portion203 and the yaw manipulation portion202 may be rotated together with the pitch manipulation portion201. In other words, when the user pitch-rotates the first handle204 around the rotation shaft246, the actuation manipulation portion203, the yaw manipulation portion202, and the pitch manipulation portion201 may also move together with the first handle204.

The pulley217, the pulley218, the pulley227, and the pulley228 may be coupled to the rotation shaft246 so that they are rotatable around the rotation shaft246 of the pitch frame208.

Here, the pulley217 and the pulley218 may face each other and rotate independently. Accordingly, as the wire wound inward and the wire wound outward may be respectively wound around separate pulleys, the pulleys may operate without interfering with each other. Likewise, the pulley227 and the pulley228 may face each other and rotate independently. Accordingly, as the wire wound inward and the wire wound outward may be respectively wound around separate pulleys, the pulleys may operate without interfering with each other.

Next, the motions of the wire303 and the wire304 which are the pitch wire are described below.

In the end tool1100, the pulley1131, which is the end tool pitch pulley, may be fixedly coupled to the end tool hub1180, and in the manipulation portion200, the pulley231 and the pulley232, which are the manipulation portion pitch pulley, may be fixedly coupled to the pitch frame208. These pulleys may be connected to each other by the wire303 and the wire304, which are the pitch wire, to facilitate the pitch motion of the end tool1100 according to the pitch manipulation of the manipulation portion200. Here, the wire303 may be fixedly coupled to the pitch frame208 via the pulley231 and the pulley233, and the wire304 may be fixedly coupled to the pitch frame208 via the pulley232 and the pulley234. That is, the pitch frame208, the pulley231, and the pulley232 may rotate together around the rotation shaft246 by the pitch rotation of the manipulation portion200. As a result, the wire303 and the wire304 may also move, and separately from the pitch motion of the end tool1100 by the wire301, the wire302, the wire305, and the wire306, which are the jaw wire, additional pitch rotation power may be transmitted.

The connection relation among the first handle204, the pitch manipulation portion201, the yaw manipulation portion202, and the actuation manipulation portion203 is described below. On the first handle204, the rotation shaft241, the rotation shaft242, the rotation shaft243, the rotation shaft244, the rotation shaft245, and the rotation shaft246 may be formed. At this time, as the rotation shaft241 and the rotation shaft242 are directly formed on the first handle204, the first handle204 and the actuation manipulation portion203 may be directly connected to each other. As the rotation shaft243 is directly formed on the first handle204, the first handle204 and the yaw manipulation portion202 may be directly connected to each other. As the pitch manipulation portion201 is arranged on one side of the yaw manipulation portion202 and connected to the yaw manipulation portion202, the pitch manipulation portion201 may not be directly connected to the first handle204 and the pitch manipulation portion201 and the first handle204 may be indirectly connected to each other through the yaw manipulation portion202.

With reference to the drawings, in the electric cauterization surgical instrument10 according to the first embodiment, the pitch manipulation portion201 and the end tool1100 may be formed on the same or parallel axis (i.e., the X-axis). That is, the rotation shaft246 of the pitch manipulation portion201 may be formed at one end of the bent portion402 of the connection portion400, and the end tool1100 may be formed at the other end of the connection portion400.

In addition, one or more intermediate pulleys235 changing or guiding a path of the wires may be arranged in some positions of the connection portion400, in particular, in positions on the bent portion402. At least a part of the wires may be wound around the intermediate pulleys235 to guide the path of the wires so that the wires are arranged along the bent shape of the bent portion402.

Here, the drawings illustrate that the connection portion400 includes the bent portion402 and thus is formed in a curved manner with a certain curvature; however, the technical concepts of the present disclosure are not limited thereto, and the connection portion400 may be formed straightly, if necessary, or curved in one or more points. Even in such cases, the pitch manipulation portion201 and the end tool1100 may be formed on the substantially same or parallel axis. In addition, althoughFIG.3 illustrates that the pitch manipulation portion201 and the end tool1100 are respectively formed on an axis parallel with the X-axis, the technical concepts of the present disclosure are not limited thereto, and the pitch manipulation portion201 and the end tool1100 may be formed on different axes.

(Actuation Motion, Yaw Motion, Pitch Motion)

Actuation motion, yaw motion, and pitch motion in this embodiment will be described as follows.

First, the actuation motion is as follows.

When a user puts the index finger in a hand ring formed at the first actuation extension252, puts the thumb in a hand ring formed at the second actuation extension257, and rotates the first actuation extension252 and the second actuation extension257 using any one of or both the fingers, the pulley210 and the first actuation gear253 fixedly coupled to the first actuation extension252 rotate around the rotation shaft241, and the pulley220 and the second actuation gear258 fixedly coupled to the second actuation extension257 rotate around the rotation shaft242. At this time, the pulley210 and the pulley220 rotate in opposite directions, and thus the wire301 and the wire305 each having one end fixedly coupled to and wound around the pulley210 and the wire302 and the wire306 each having one end fixedly coupled to and wound around the pulley220 move in opposite directions as well. This rotational force is transmitted to an end tool1100 through a power transmission portion300, two jaws1103 of the end tool1100 perform the actuation motion.

Here, the actuation motion refers to an action of opening or closing the jaws1102 while the two jaws1102 rotate in opposite directions to each other, as described above. In other words, when the actuation extensions252 and257 of the actuation manipulation portion203 are rotated in directions toward each other, the first jaw1101 rotates counterclockwise and the second jaw1102 rotates clockwise, and thus the end tool1100 is closed. Conversely, when the actuation extensions252 and257 of the actuation manipulation portion203 are rotated in directions away from each other, the first jaw1101 rotates clockwise and the second jaw1102 rotates counterclockwise, and thus the end tool1100 is opened.

In this embodiment, for the above-described actuation manipulation, the first actuation extension252 and the second actuation extension257 were provided to constitute a second handle, and two fingers were gripped to enable manipulation. However, unlike the above, the actuation manipulation portion203 for actuation manipulation to open and close the two jaws of the end tool1100 with each other may be configured differently so that, for example, two actuation pulleys (the pulley210 and the pulley220) operate opposite to each other by one actuation rotating portion.

Next, the yaw motion is as follows.

When the user rotates a first handle204 around a rotation shaft243 while holding the first handle204, the actuation manipulation portion203 and the yaw manipulation portion202 yaw-rotates around the rotation shaft243. In other words, when the pulley210 of the first actuation manipulation portion251 to which the wire301 and the wire305 are fixedly coupled rotates about the rotation shaft243, the wire301 and the wire305 respectively wound around the pulley211 and the pulley212 move. Likewise, when the pulley220 of the second actuation manipulation portion256 to which the wire302 and the wire306 are fixedly coupled rotates about the rotation shaft243, the wire302 and the wire306 respectively wound around the pulley221 and the pulley222 move. At this time, the wire301 and the wire305 connected to the first jaw1101 and the wire302 and the wire306 connected to the second jaw1102 are respectively wound around the pulley211 and the pulley212 and the pulley221 and the pulley222, such that the first jaw1101 and the second jaw1102 rotate in the same direction during a yaw rotation. And, this rotational force is transmitted to the end tool1100 through the power transmission portion300, the two jaws1103 of the end tool1100 performs the yaw motion that rotates in the same direction.

At this time, since the yaw frame207 connects the first handle204, the rotation shaft241, the rotation shaft242, and the rotation shaft243, the first handle204, the yaw manipulation portion202, and the actuation manipulation portion203 rotate together around the rotation shaft243.

Next, the pitch motion is as follows.

When the user rotates a first handle204 around a rotation shaft246 while holding the first handle204, the actuation manipulation portion203, the yaw manipulation portion202, and the pitch manipulation portion201 make pitch rotation around the rotation shaft243. In other words, when the pulley210 of the first actuation manipulation portion251 to which the wire301 and the wire305 are fixedly coupled rotates about the rotation shaft246, the wire301 and the wire305 respectively wound around the pulley217 and the pulley218 move. Likewise, when the pulley220 of the second actuation manipulation portion256 to which the wire302 and the wire306 are fixedly coupled rotates about the rotation shaft246, the wire302 and the wire306 respectively wound around the pulley227 and the pulley228 move. Here, as described above with reference toFIG.5, the wire301, the wire305, the wire302, and the wire306, which are jaw wires, are wound around the pulley217, the pulley218, the pulley227, and the pulley228, which are manipulation portion pitch main pulleys, such that the wire301 and wire305, which are first jaw wires, move in the same direction and the wire302 and the wire306, which are second jaw wires, move in the same direction to enable pitch rotation of the first jaw1101 and the second jaw1102. And, this rotational force is transmitted to an end tool1100 through a power transmission portion300, two jaws1103 of the end tool1100 perform the pitch motion.

At this time, the pitch frame208 is connected to the yaw frame207 and the yaw frame207 connects the first handle204, the rotation shaft241, the rotation shaft242, and the rotation shaft243. Therefore, when the pitch frame208 rotates around the rotation shaft246, the yaw frame207 connected to the pitch frame208, the first handle204, the rotation shaft241, the rotation shaft242, and the rotation shaft243 rotate together. That is, when a pitch manipulation portion201 rotates around the rotation shaft246, the actuation manipulation portion203 and the yaw manipulation portion202 are rotated together with the pitch manipulation portion201.

In summary, in an electric cauterization surgical instrument10 according to an embodiment of the present disclosure, it is characterized that pulleys are formed at each joint point (actuation joint, yaw joint, pitch joint), wire (first jaw wire or second jaw wire) is wound on the pulley, and rotational manipulation of the manipulation portion (actuation rotation, yaw rotation, pitch rotation) causes movement of each wire, as a result, a desired motion of the end tool1100 is induced. Furthermore, auxiliary pulleys may be formed on one side of each pulley, and the wire may not be wound several times on one pulley by these auxiliary pulleys.

FIG.218 is a schematic view of only the configuration of pulleys and wires constituting joints of the electric cauterization surgical instrument10 according to an embodiment of the present disclosure shown inFIG.140. InFIG.218, intermediate pulleys that are for changing paths of wires and are not associated with joint motions are omitted.

Referring toFIG.218, the manipulation portion200 may include the pulley210, the pulley211, the pulley212, the pulley213, the pulley214, the pulley215, the pulley216, the pulley217, and the pulley218 that are associated with the rotational motion of the first jaw1101.

Also, the manipulation portion200 may include the pulley220, the pulley221, the pulley222, the pulley223, the pulley224, the pulley225, the pulley226, the pulley227, and the pulley228 associated with the rotational motion of the second jaw1102. (The arrangement and the configuration of pulleys in the manipulation portion200 are the same as the arrangement and the configuration of the pulleys in the end tool1100 in principle, and thus some of the reference numerals thereof will be omitted in the drawings.)

The pulley211 and the pulley212 and the pulley221 and the pulley222 may be formed to be rotatable independently of each other around the same axis, that is, the rotation shaft243. At this time, the pulley211 and the pulley212 may be formed to face the pulley221 and the pulley222, respectively, thereby forming two independently rotatable pulleys.

The pulley213 and the pulley214 and the pulley223 and the pulley224 may be formed to be rotatable independently of each other around the same axis, that is, the rotation shaft244. At this time, the pulley213 and the pulley214 may be formed to face each other as two independently rotatable pulleys, and, in this case, the two pulleys may be formed to have different diameters. Likewise, the pulley223 and the pulley224 may be formed to face each other as two independently rotatable pulleys, and, in this case, the two pulleys may be formed to have different diameters.

The pulley215 and the pulley216 and the pulley225 and the pulley226 may be formed to be rotatable independently of each other around the same axis, that is, the rotation shaft245. In this case, the pulley215 and the pulley216 may be formed to have different diameters. Also, the pulley225 and the pulley226 may be formed to have different diameters.

The pulley217 and the pulley218 and the pulley227 and the pulley228 may be formed to be rotatable independently of each other around the same axis, that is, the rotation shaft246.

The wire301 sequentially passes through the pulley217, the pulley215, the pulley213, and the pulley211 of the manipulation portion200, is wound around the pulley210, and then is coupled to the pulley210 by a fastening member324. Meanwhile, the wire305 sequentially passes through the pulley218, the pulley216, the pulley214, and the pulley212 of the manipulation portion200 and is coupled to the pulley210 by the fastening member324. Therefore, as the pulley210 rotates, the wire301 and the wire305 are wound around or unwound from the pulley210, and thus the first jaw1101 rotates.

The wire306 sequentially passes through the pulley227, the pulley225, the pulley223, and the pulley221 of the manipulation portion200, is wound around the pulley220, and then is coupled to the pulley220 by a fastening member327. Meanwhile, the wire302 sequentially passes through the pulley228, the pulley226, the pulley224, and the pulley222 of the manipulation portion200 and is coupled to the pulley220 by the fastening member327. Therefore, as the pulley220 rotates, the wire302 and the wire306 are wound around or unwound from the pulley220, and thus the second jaw1102 rotates.

(Conceptual Diagram of Pulleys and Wires)

FIGS.220 and221 are diagrams illustrating a configuration of pulleys and wires, which are associated with an actuation motion and a yaw motion of the electric cauterization surgical instrument10 according to an embodiment of the present disclosure illustrated inFIG.140, in detail for each of the first jaw and the second jaw.FIG.220 is a diagram illustrating only pulleys and wires related to the second jaw, andFIG.221 is a diagram illustrating only pulleys and wires related to the first jaw. In addition,FIG.219 is a perspective view illustrating a yaw motion of the surgical instrument shown inFIG.140. Here, inFIG.219, components associated with a cutting motion are omitted.

First, a wire operation in an actuation motion will be described.

Referring toFIG.221, when the first actuation extension252 rotates around the rotation shaft241 in the direction of an arrow OPA1, the pulley210 connected to the first actuation extension252 is rotated, and the wire301 and the wire305 wound around the pulley210 are moved in directions W1aand W1b, respectively, and as a result, the first jaw1101 of the end tool1100 is rotated in the direction of an arrow EPA1.

Referring toFIG.220, when the second actuation extension257 rotates around the rotation shaft242 in the direction of an arrow OPA2, the pulley220 connected to the second actuation extension257 is rotated, and thus both strands of the wires302 and306 wound around the pulley220 are moved in directions W2aand W2b, respectively, and as a result, the second jaw1102 of the end tool1100 is rotated in the direction of an arrow EPA2. Accordingly, when a user manipulates the first actuation extension252 and the second actuation extension257 in directions close to each other, a motion of the first jaw1101 and the second jaw1102 of the end tool being close to each other is performed.

Next, a wire operation in a yaw motion will be described.

First, since the rotation shaft243 is connected to the rotation shafts241 and242 by the yaw frame (see207 ofFIG.216), the rotation shaft243 and the rotation shafts241 and242 are integrally rotated together.

Referring toFIG.221, when the first handle204 rotates around the rotation shaft243 in the direction of an arrow OPY1, the pulley210 and the pulleys211 and212 and the wires301 and305 wound therearound are rotated as a whole around the rotation shaft243, and as a result, the wires301 and305 wound around the pulleys211 and212 are moved in the directions W1aand W1b, respectively, which in turn causes the first jaw1101 of the end tool1100 to rotate in the direction of an arrow EPY1.

Referring toFIG.220, when the first handle204 rotates around the rotation shaft243 in the direction of an arrow OPY2, the pulley220 and the pulleys221 and222 and the wires302 and306 wound therearound are rotated as a whole around the rotation shaft243, and as a result, the wires302 and306 wound around the pulleys221 and222 are respectively moved in a direction opposite to the direction W1aand a direction opposite to the direction W1b, which in turn causes the first jaw1101 of the end tool1100 to rotate in the direction of an arrow EPY2.

FIGS.223 and224 are diagrams illustrating a configuration of pulleys and wires, which are associated with a pitch motion of the electric cauterization surgical instrument10 according to an embodiment of the present disclosure illustrated inFIG.140, in detail for each of the first jaw and the second jaw.FIG.223 is a diagram illustrating only pulleys and wires related to the second jaw, andFIG.224 is a diagram illustrating only pulleys and wires related to the first jaw. As shown inFIG.140 and elsewhere herein, there are two pulleys related to the pitch motion, and both strands of each wire are wound in the same path, which is illustrated with one line inFIG.223. In addition,FIG.222 is a perspective view illustrating a pitch motion of the surgical instrument ofFIG.140. Here, inFIG.222, components associated with a cutting motion are omitted.

Referring toFIG.223, when the first handle204 rotates around the rotation shaft246 in the direction of an arrow OPP1, the pulley210, the pulley215, the pulley217, and the like, and the wire301 and the like wound therearound are rotated as a whole around the rotation shaft246. At this time, since the wires301 and305, which are first jaw wires, are wound around upper portions of the pulley217 and the pulley218, the wires301 and305 are moved in the direction of an arrow W1. As a result, the first jaw1101 of the end tool1100 rotates in the direction of an arrow EPP1.

Referring toFIG.224, when the first handle204 rotates around the rotation shaft246 in the direction of an arrow OPP2, the pulley220, the pulley225, the pulley227, and the like, and the wire302 and the like wound therearound are rotated as a whole around the rotation shaft246. At this time, since the wires302 and306, which are second jaw wires, are wound around lower portions of the pulley227 and the pulley228, the wires302 and306 are moved in the direction of an arrow W2. As a result, the second jaw1102 of the end tool1100 rotates in the direction of an arrow EPP2.

Thus, the actuation, yaw, and pitch manipulations are manipulatable independent of each other.

As described with reference toFIG.140, the actuation manipulation portion203, the yaw manipulation portion202, and the pitch manipulation portion201 are configured such that the respective rotation shafts are located at the rear thereof to be identical to the joint configuration of the end tool, so that a user may intuitively perform matching manipulations.

In particular, in the electric cauterization surgical instrument10 according to an embodiment of the present disclosure, the pulleys are formed on respective joint points (an actuation joint, a yaw joint, and a pitch joint), the wires (the first jaw wire or the second jaw wire) are formed to be wound around the pulleys, the rotational manipulations (actuation rotation, yaw rotation, and pitch rotation) of the manipulation portion cause the movement of each wire, which in turn induces the desired motion of the end tool1100. Furthermore, the auxiliary pulleys may be formed on one side of the respective pulleys, and these auxiliary pulleys may prevent the wire from being wound around one pulley multiple times, so that the wires wound around the pulley do not come into contact with each other, and paths of the wire being wound around the pulley and the wire being released from the pulley are safely formed, so that safety and efficiency in the transmission of driving force of a wire may be improved.

Meanwhile, as described above, the yaw manipulation portion202 and the actuation manipulation portion203 are directly formed on the first handle204. Thus, when the first handle204 rotates around the rotation shaft246, the yaw manipulation portion202 and the actuation manipulation portion203 are also rotated together with the first handle204. Accordingly, the coordinate systems of the yaw manipulation portion202 and the actuation manipulation portion203 are not fixed, but are continuously changed relative to the rotation of the first handle204. That is, inFIG.140 or the like, the yaw manipulation portion202 and the actuation manipulation portion203 are illustrated as being parallel to the Z-axis. However, when the first handle204 is rotated, the yaw manipulation portion202 and the actuation manipulation portion203 are not parallel to the Z-axis any longer. That is, the coordinate systems of the yaw manipulation portion202 and the actuation manipulation portion203 arc changed according to the rotation of the first handle204. However, in the present specification, for convenience of description, unless described otherwise, the coordinate systems of the yaw manipulation portion202 and the actuation manipulation portion203 are described on the basis of a state in which the first handle204 is located perpendicular to the connection portion400 as illustrated inFIG.2.

(Pitch, Yaw, and Cutting Motions of End Tool)

FIGS.168 and169 are views illustrating a process of performing an opening and closing motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.140 is yaw-rotated by +90°. In addition,FIGS.170 and171 are views illustrating a process of performing an opening and closing motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.140 is yaw-rotated by −90°.

As shown inFIGS.168 to171, the end tool of the surgical instrument for electrocautery according to the fourth embodiment of the present disclosure is formed to be able to normally perform an opening and closing motion, that is, an actuation motion even in a state in which the jaws are yaw-rotated by +90° or −90°.

FIGS.172 and173 are views illustrating a process of performing a cutting motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.140 is yaw-rotated by +90°.

As shown inFIGS.172 and173, the end tool of the surgical instrument for electrocautery according to the fourth embodiment of the present disclosure is formed to be able to normally perform a cutting motion even in a state in which the jaws are yaw-rotated by +90°.

FIGS.174 and175 are views illustrating a process of performing an opening and closing motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.140 is pitch-rotated by +90°.FIGS.176 and177 are views illustrating a process of performing an opening and closing motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.140 is pitch-rotated by −90°. In addition,FIG.178 is a cut-away perspective view of the end tool of the surgical instrument for electrocautery ofFIG.176. In addition,FIGS.179 and180 are views illustrating a process of performing a cutting motion in a state in which the end tool of the surgical instrument for electrocautery ofFIG.140 is pitch-rotated by −90°.

As shown inFIGS.174 to180, the end tool of the surgical instrument for electrocautery according to the fourth embodiment of the present disclosure is formed to be able to normally perform a cutting motion even in a state in which the jaws are pitch-rotated by −90°.

Meanwhile,FIG.181 is a view illustrating a state in which the jaws are pitch-rotated by −90° and simultaneously yaw-rotated by +90°, andFIGS.182,183, and184 are perspective views illustrating a cutting motion of the end tool of the surgical instrument for electrocautery ofFIG.140 and illustrate a state of performing a cutting motion while the jaws are pitch-rotated by −90° and simultaneously yaw-rotated by +90°.

As shown inFIGS.181 to184, the end tool of the surgical instrument for electrocautery according to the fourth embodiment of the present disclosure is formed to be able to normally perform a cutting motion even in a state in which the jaws are pitch-rotated by −90° and simultaneously yaw-rotated by +90°.

First Modified Example of Fourth Embodiment

Hereinafter, an end tool1200 of a surgical instrument according to a first modified example of the fourth embodiment of the present disclosure will be described. Here, the end tool1200 of the surgical instrument according to the first modified example of the fourth embodiment of the present disclosure is different from the end tool (see1100 inFIG.140 or the like) of the surgical instrument according to the fourth embodiment of the present disclosure described above in that the configuration of an actuation hub1290 is different. The configuration changed from the fourth embodiment as described above will be described in detail later.

FIGS.185 and186 are perspective views illustrating the end tool of the surgical instrument for electrocautery according to the first modified example of the fourth embodiment of the present disclosure.FIGS.187 and188 are plan views illustrating the end tool of the surgical instrument for electrocautery according to the first modified example of the fourth embodiment of the present disclosure.FIGS.189 and190 are views illustrating an actuation hub of the surgical instrument for electrocautery according to the first modified example of the fourth embodiment of the present disclosure.

Referring toFIGS.185 to190, the end tool1200 of the first modified example of the fourth embodiment of the present disclosure includes a pair of jaws for performing a grip motion, that is, a first jaw1201 and a second jaw1202, and herein, each of the first jaw1201 and the second jaw1202 or a component encompassing the first jaw1201 and the second jaw1202 may be referred to as a jaw1203.

Meanwhile, the end tool1200 includes a plurality of pulleys including a pulley1211, a pulley1213, and a pulley1214 that are associated with a rotational motion of the first jaw1201. Meanwhile, the end tool1200 includes a plurality of pulleys including a pulley1221 associated with a rotational motion of the second jaw1202.

In addition, the end tool1200 of the first modified example of the fourth embodiment of the present disclosure may include a rotation shaft1241, a rotation shaft1243, and a rotation shaft1244. Here, the rotation shaft1241 may be inserted through an end tool hub1260, and the rotation shaft1243 and the rotation shaft1244 may be inserted through a pitch hub1250. The rotation shaft1241, the rotation shaft1243, and the rotation shaft1244 may be arranged sequentially from a distal end1204 toward a proximal end1205 of the end tool1200.

Further, the end tool1200 of the first modified example of the fourth embodiment of the present disclosure may include the end tool hub1260 and the pitch hub1250.

The rotation shaft1241 is inserted through the end tool hub1260, and the pulley1211 and the pulley1221, which are axially coupled to the rotation shaft1241, and at least some of the first jaw1201 and the second jaw1202 coupled the pulley1211 and the pulley1221 may be accommodated inside the end tool hub1260.

Meanwhile, a first pitch pulley portion1263aand a second pitch pulley portion1263b, which serve as end tool pitch pulleys, may be formed at one end portion of the end tool hub1260. A wire (see303 ofFIG.146) and a wire304 (see304 ofFIG.146) are coupled to the first pitch pulley portion1263aand the second pitch pulley portion1263b, which serve as end tool pitch pulleys, and a pitch motion is performed while the end tool hub1260 rotates around the rotation shaft1243.

The rotation shaft1243 and the rotation shaft1244 may be inserted through the pitch hub1250, and the pitch hub1250 may be axially coupled to the end tool hub1260 by the rotation shaft1243. Accordingly, the end tool hub1260 may be formed to be pitch-rotatable around the rotation shaft1243 with respect to the pitch hub1250.

Meanwhile, the end tool1200 of the fourth embodiment of the present disclosure may further include components such as a first electrode1251, a second electrode1252, a guide tube1271, and a blade1275 in order to perform a cauterizing motion and a cutting motion. Here, components related to the driving of the blade, such as the guide tube1271 and the blade1275, may be collectively referred to as a blade assembly. Components for performing a cauterizing motion and a cutting motion in the present embodiment are substantially the same as those described in the fourth embodiment, and thus a detailed description thereof will be omitted herein.

The surgical instrument for electrocautery according to the first modified example of the fourth embodiment of the present disclosure may include a wire301, a wire302, a wire303, a wire304, a wire305, a wire306, and a blade wire307, as in the fourth embodiment of the present disclosure described with reference toFIG.140 or the like.

Hereinafter, the actuation hub1290 of the first modified example of the fourth embodiment of the present disclosure will be described in more detail.

Referring toFIGS.185 to190, the actuation hub1290 may be formed in the form of a box having a hollow therein. Here, a first coupling hole1290ais formed in any one surface of the actuation hub1290, specifically, a surface coming into contact with the first jaw1201, and a second coupling hole1290bmay be formed in the other surface of the actuation hub1290, specifically, a surface coming into contact with the second jaw1202.

In this case, the first coupling hole1290amay be formed to be offset to a certain degree in one direction from the center line in the X-axis direction. In addition, the second coupling hole1290bmay be formed by being offset to a certain degree in another one direction from the center line in the X-axis direction.

In other words, it may be said that the first coupling hole1290aand the second coupling hole1290bare not on the same line in the Z-axis direction but are formed to be offset to a certain degree.

In addition, the actuation hub1290 is coupled to each of the first jaw1201 and the second jaw1202. In detail, a first actuation rotation shaft1291 is inserted through the first jaw1201 and the first coupling hole1290aof the actuation hub1290, so that the actuation hub1290 and the first jaw1201 are axially coupled. Further, a second actuation rotation shaft1292 is inserted through the second jaw1202 and the second coupling hole1290B of the actuation hub1290, so that the actuation hub1290 and the second jaw1202 are axially coupled.

Meanwhile, as described with reference toFIG.154 or the like, a tube seating portion, a wire through-hole, and a blade accommodation portion are sequentially formed inside the actuation hub1290, and the blade wire307 may pass through the inside of the actuation hub1290 to be connected to the blade1275.

As described above, by providing the actuation hub1290 to which the guide tube1270 is coupled between the first jaw1201 and the second jaw1202, the guide tube1270 may not be curved, or the angle at which the guide tube1270 is curved may be reduced, even when the first jaw1201 or the second jaw1202 rotates around the first rotation shaft1241 or the actuation rotation shaft1245.

In detail, in a case in which the guide tube1270 is directly coupled to the first jaw1201 or the second jaw1202, when the first jaw1201 or the second jaw1202 rotates, one end portion of the guide tube1270 also rotates together with the first jaw1201 or the second jaw1202, causing the guide tube1270 to be curved.

On the other hand, in a case in which the guide tube1270 is coupled to the actuation hub1290, which is independent of the rotation of the jaw1203, as in the present embodiment, even when the first jaw1201 or the second jaw1202 rotates, the guide tube1270 may not be curved, or the angle at which the guide tube1270 is curved may be reduced even when the guide tube1270 is curved.

That is, by changing the direct connection between the guide tube1270 and the jaw1203 by the actuation hub1290 to an indirect connection, the degree to which the guide tube1270 is curved by the rotation of the jaw1203 may be reduced.

In particular, in the end tool1200 of the first modified example of the fourth embodiment of the present disclosure, when the actuation hub1290 is coupled to the first jaw1201 and the second jaw1202, the first actuation rotation shaft1291 and the second actuation rotation shaft1292 are not on the same line in the Z-axis direction but are offset from each other to a certain degree. Thus, when the first jaw1201 and the second jaw1202 perform an actuation motion, the first actuation rotation shaft1291 and the second actuation rotation shaft1292 form a kind of two-point support, thereby obtaining an effect of more stably performing an actuation motion.

Second Modified Example of Fourth Embodiment

Hereinafter, an end tool1300 of a surgical instrument according to a second modified example of the fourth embodiment of the present disclosure will be described. Here, the end tool1300 of the surgical instrument according to the second modified example of the fourth embodiment of the present disclosure is different from the end tool (see1100 inFIG.140 or the like) of the surgical instrument according to the fourth embodiment of the present disclosure described above in that the configuration of an actuation hub1390 is different. The configuration changed from the fourth embodiment as described above will be described in detail later.

FIGS.191 to196 are views illustrating the end tool of the surgical instrument for electrocautery according to the second modified example of the fourth embodiment of the present disclosure.FIGS.197 and198 are views illustrating an actuation hub of the end tool of the surgical instrument for electrocautery ofFIG.191.FIG.199 is a perspective view illustrating a second jaw pulley of the end tool of the surgical instrument for electrocautery ofFIG.191.FIGS.200 and201 are views illustrating the end tool of the surgical instrument for electrocautery ofFIG.191.

Referring toFIGS.191 to201, the end tool1300 of the second modified example of the fourth embodiment of the present disclosure includes a pair of jaws for performing a grip motion, that is, a first jaw1301 and a second jaw1302, and herein, each of the first jaw1301 and the second jaw1302 or a component encompassing the first jaw1301 and the second jaw1302 may be referred to as a jaw1303.

Meanwhile, the end tool1300 includes a plurality of pulleys including a pulley1311, a pulley1313, and a pulley1314 associated with a rotational motion of a first jaw1301. Meanwhile, the end tool1300 includes a plurality of pulleys including a pulley1321 associated with a rotational motion of the second jaw1302.

In addition, the end tool1300 of the second modified example of the fourth embodiment of the present disclosure may include a rotation shaft1341, a rotation shaft1343, and a rotation shaft1344. Here, the rotation shaft1341 may be inserted through an end tool hub1360, and the rotation shaft1343 and the rotation shaft1344 may be inserted through a pitch hub1350.

In addition, the end tool1300 of the second modified example of the fourth embodiment of the present disclosure may include the end tool hub1360 and the pitch hub1350.

Meanwhile, the end tool1300 of the second modified example of the fourth embodiment of the present disclosure may further include components such as a first electrode1351, a second electrode1352, a guide tube1371, and a blade1375 in order to perform a cauterizing motion and a cutting motion.

The surgical instrument for electrocautery according to the second modified example of the fourth embodiment of the present disclosure may include a wire301, a wire302, a wire303, a wire304, a wire305, a wire306, and a blade wire307, as in the fourth embodiment of the present disclosure described with reference toFIG.140 or the like.

Since components of the present modified example described above are substantially the same as the components described in the fourth embodiment, a detailed description thereof will be omitted herein.

Hereinafter, the actuation hub1390 of the second modified example of the fourth embodiment of the present disclosure will be described in more detail.

Referring toFIGS.191 to201, the actuation hub1390 may be formed in the form of a box having a hollow therein.

Here, a first coupling hole1390ais formed in any one surface of the actuation hub1390, specifically, a surface coming into contact with the first jaw1301, and a second coupling hole1390bmay be formed in the other surface of the actuation hub1390, specifically, a surface coming into contact with the second jaw1302.

In this case, the first coupling hole1390amay be formed to be offset to a certain degree in one direction from the center line in the X-axis direction. In addition, the second coupling hole1390bmay be formed by being offset to a certain degree in another one direction from the center line in the X-axis direction.

In other words, it may be said that the first coupling hole1390aand the second coupling hole1390bare not on the same line in the Z-axis direction but are formed to be offset to a certain degree.

In addition, the actuation hub1390 is coupled to each of the first jaw1301 and the second jaw1302. In detail, a first actuation rotation shaft1391 is inserted through the first jaw1301 and the first coupling hole1390aof the actuation hub1390, so that the actuation hub1390 and the first jaw1301 are axially coupled. Further, a second actuation rotation shaft1392 is inserted through the second jaw1302 and the second coupling hole1390bof the actuation hub1390, so that the actuation hub1390 and the second jaw1302 are axially coupled.

Meanwhile, as described with reference toFIG.154 or the like, a tube seating portion, a wire through-hole, and a blade accommodation portion are sequentially formed inside the actuation hub1390, and the blade wire307 may pass through the inside of the actuation hub1390 to be connected to the blade1375.

In addition, a guide slit1390cmay be formed in any one surface of the actuation hub1390 or in both surfaces thereof in a longitudinal direction thereof (i.e., the X-axis direction). In addition, a slit coupling portion1321cformed on the pulley1321 may be fitted into the guide slit1390c, so that a linear movement of the pulley1321 in the X-axis direction may be guided by the guide slit1390c.

In detail, a shaft coupling portion1321a, a jaw coupling portion1321b, and the slit coupling portion1321cmay be formed on the pulley1321. Here, the shaft coupling portion1321aand the jaw coupling portion1321bmay be formed in the same manner as described in the fourth embodiment or the like. The slit coupling portion1321cmay be formed to protrude to a certain degree further from the shaft coupling portion1321a. The above-described slit coupling portion1321cis fitted into the guide slit1390cof the actuation hub1390.

Meanwhile, although not shown in the drawings, a slit coupling portion (not shown) may also be formed in the pulley1311.

As described above, by providing the actuation hub1390 to which the guide tube1370 is coupled between the first jaw1301 and the second jaw1302, the guide tube1370 may not be curved, or the angle at which the guide tube1370 is curved may be reduced, even when the first jaw1301 or the second jaw1302 rotates around the first rotation shaft1341 or the actuation rotation shaft1345.

In detail, in a case in which the guide tube1370 is directly coupled to the first jaw1301 or the second jaw1302, when the first jaw1301 or the second jaw1302 rotates, one end portion of the guide tube1370 also rotates together with the first jaw1301 or the second jaw1302, causing the guide tube1370 to be curved.

On the other hand, in a case in which the guide tube1370 is coupled to the actuation hub1390, which is independent of the rotation of the jaw1303, as in the present embodiment, even when the first jaw1301 or the second jaw1302 rotates, the guide tube1370 may not be curved, or the angle at which the guide tube1370 is curved may be reduced even when the guide tube1370 is curved.

That is, by changing the direct connection between the guide tube1370 and the jaw1303 by the actuation hub1390 to an indirect connection, the degree to which the guide tube1370 is curved by the rotation of the jaw1303 may be reduced.

In particular, in the end tool1300 of the second modified example of the fourth embodiment of the present disclosure, when the actuation hub1390 is coupled to the first jaw1301 and the second jaw1302, the first actuation rotation shaft1391 and the second actuation rotation shaft1392 are not on the same line in the Z-axis direction but are offset to a certain degree. Thus, when the first jaw1301 and the second jaw1302 perform an actuation motion, the first actuation rotation shaft1391 and the second actuation rotation shaft1392 form a kind of two point support, thereby obtaining an effect of more stably performing an actuation motion.

In addition, in the end tool1300 of the second modified example of the fourth embodiment of the present disclosure, the slit coupling portion1321cformed on the pulley1321 is fitted into the guide slit1390cof the actuation hub1390 so that the linear movement of the pulley1321 in the X-axis direction may be guided by the guide slit1390c. That is, when the first jaw1301 and the second jaw1302 perform an actuation motion, the first jaw1301 and the second jaw1302 move along the guide slit1390cof the actuation hub1390, thereby obtaining an effect of more stably performing the actuation motion.

Third Modified Example of Fourth Embodiment

Hereinafter, an end tool1400 of a surgical instrument according to a third modified example of the fourth embodiment of the present disclosure will be described. Here, the end tool1400 of the surgical instrument according to the third modified example of the fourth embodiment of the present disclosure is different from the end tool (see1100 inFIG.140 or the like) of the surgical instrument according to the fourth embodiment of the present disclosure described above in that the configuration of an actuation hub1490 is different. The configuration changed from the fourth embodiment as described above will be described in detail later.

FIGS.202 to205 are views illustrating the end tool of the surgical instrument for electrocautery according to the third modified example of the fourth embodiment of the present disclosure.FIGS.206 and207 are views illustrating an actuation hub of the end tool of the surgical instrument for electrocautery ofFIG.202.FIG.208 is a perspective view illustrating a second jaw pulley of the end tool of the surgical instrument for electrocautery ofFIG.202.

Referring toFIGS.202 to208, the end tool1400 of the third modified example of the fourth embodiment of the present disclosure includes a pair of jaws for performing a grip motion, that is, a first jaw1401 and a second jaw1402, and herein, each of the first jaw1401 and the second jaw1402 or a component encompassing the first jaw1401 and the second jaw1402 may be referred to as a jaw1403.

Meanwhile, the end tool1400 includes a plurality of pulleys including a pulley1411, a pulley1413, and a pulley1414 that are associated with a rotational motion of the first jaw1401. Meanwhile, the end tool1400 includes a plurality of pulleys including a pulley1421 associated with a rotational motion of the second jaw1402.

In addition, the end tool1400 of the third modified example of the fourth embodiment of the present disclosure may include a rotation shaft1441, a rotation shaft1443, and a rotation shaft1444. Here, the rotation shaft1441 may be inserted through an end tool hub1460, and the rotation shaft1443 and the rotation shaft1444 may be inserted through a pitch hub1450.

In addition, the end tool1400 of the third modified example of the fourth embodiment of the present disclosure may include the end tool hub1460 and the pitch hub1450.

Meanwhile, the end tool1400 of the third modified example of the fourth embodiment of the present disclosure may further include components such as a first electrode1451, a second electrode1452, a guide tube1471, and a blade1475 in order to perform a cauterizing motion and a cutting motion.

The surgical instrument for electrocautery according to the third modified example of the fourth embodiment of the present disclosure may include a wire301, a wire302, a wire303, a wire304, a wire305, a wire306, and a blade wire307, as in the fourth embodiment of the present disclosure described with reference toFIG.140 or the like.

Since components of the present modified example described above are substantially the same as the components described in the fourth embodiment, a detailed description thereof will be omitted herein.

Hereinafter, the actuation hub1490 of the third modified example of the fourth embodiment of the present disclosure will be described in more detail.

Referring toFIGS.202 to208, the actuation hub1490 may be formed in the form of a box having a hollow therein.

Here, a first coupling hole1490ais formed in any one surface of the actuation hub1490, specifically, a surface coming into contact with the first jaw1401, and a second coupling hole1490bmay be formed in the other surface of the actuation hub1490, specifically, a surface coming into contact with the second jaw1402.

Here, the first coupling hole1490aand the second coupling hole1490bmay be located on the same line in the Z-axis direction.

In addition, the actuation hub1490 is coupled to each of the first jaw1401 and the second jaw1402. In detail, a first actuation rotation shaft1491 is inserted through the first jaw1401 and the first coupling hole1490aof the actuation hub1490, so that the actuation hub1490 and the first jaw1401 are axially coupled. Further, a second actuation rotation shaft1492 is inserted through the second jaw1402 and the second coupling hole1490bof the actuation hub1490, so that the actuation hub1490 and the second jaw1402 are axially coupled.

Meanwhile, as described with reference toFIG.154 or the like, a tube seating portion, a wire through-hole, and a blade accommodation portion are sequentially formed inside the actuation hub1490, and the blade wire307 may pass through the inside of the actuation hub1490 to be connected to the blade1475.

In addition, a guide slit1490cmay be formed in any one surface of the actuation hub1490 or in both surfaces thereof in a longitudinal direction thereof (i.e., the X-axis direction). In addition, a slit coupling portion1421cformed on the pulley1421 may be fitted into the guide slit1490c, so that a linear movement of the pulley1421 in the X-axis direction may be guided by the guide slit1490c.

In detail, a shaft coupling portion1421a, a jaw coupling portion1421b, and the slit coupling portion1421cmay be formed on the pulley1421. Here, the shaft coupling portion1421aand the jaw coupling portion1421bmay be formed in the same manner as described in the fourth embodiment or the like. The slit coupling portion1421cmay be formed to protrude to a certain degree further from the shaft coupling portion1421a. The above-described slit coupling portion1421cis fitted into the guide slit1490cof the actuation hub1490.

Meanwhile, although not shown in the drawings, a slit coupling portion (not shown) may also be formed in the pulley1411.

As described above, by providing the actuation hub1490 to which the guide tube1470 is coupled between the first jaw1401 and the second jaw1402, the guide tube1470 may not be curved, or the angle at which the guide tube1470 is curved may be reduced, even when the first jaw1401 or the second jaw1402 rotates around the first rotation shaft1441 or the actuation rotation shaft1445.

In detail, in a case in which the guide tube1470 is directly coupled to the first jaw1401 or the second jaw1402, when the first jaw1401 or the second jaw1402 rotates, one end portion of the guide tube1470 also rotates together with the first jaw1401 or the second jaw1402, causing the guide tube1470 to be curved.

On the other hand, in a case in which the guide tube1470 is coupled to the actuation hub1490, which is independent of the rotation of the jaw1403, as in the present embodiment, even when the first jaw1401 or the second jaw1402 rotates, the guide tube1470 may not be curved, or the angle at which the guide tube1470 is curved may be reduced even when the guide tube1470 is curved.

That is, by changing the direct connection between the guide tube1470 and the jaw1403 by the actuation hub1490 to an indirect connection, the degree to which the guide tube1470 is curved by the rotation of the jaw1403 may be reduced.

In addition, in the end tool1400 of the third modified example of the fourth embodiment of the present disclosure, the slit coupling portion1421cformed on the pulley1421 is fitted into the guide slit1490cof the actuation hub1490 so that the linear movement of the pulley1421 in the X-axis direction may be guided by the guide slit1490c. That is, when the first jaw1401 and the second jaw1402 perform an actuation motion, the first jaw1401 and the second jaw1402 move along the guide slit1490cof the actuation hub1490, thereby obtaining an effect of more stably performing the actuation motion.

Fourth Modified Example of Fourth Embodiment

Hereinafter, an end tool1500 of a surgical instrument according to a fourth modified example of the fourth embodiment of the present disclosure will be described. Here, the end tool1500 of the surgical instrument according to the fourth modified example of the fourth embodiment of the present disclosure is different from the end tool (see1100 inFIG.140 or the like) of the surgical instrument according to the fourth embodiment of the present disclosure described above in that the configuration of an actuation hub1590 is different. The configuration changed from the fourth embodiment as described above will be described in detail later.

FIGS.209 to213 are views illustrating the end tool of the surgical instrument for electrocautery according to the fourth modified example of the fourth embodiment of the present disclosure.FIGS.214 and215 are views illustrating an actuation hub of the end tool of the surgical instrument for electrocautery ofFIG.209.

Referring toFIGS.209 to215, the end tool1500 of the fourth modified example of the fourth embodiment of the present disclosure includes a pair of jaws for performing a grip motion, that is, a first jaw1501 and a second jaw1502, and herein, each of the first jaw1501 and the second jaw1502 or a component encompassing the first jaw1501 and the second jaw1502 may be referred to as a jaw1503.

Meanwhile, the end tool1500 includes a plurality of pulleys including a pulley1511 and a pulley1513, and a pulley1514 that are associated with a rotational motion of the first jaw1501. Meanwhile, the end tool1500 includes a plurality of pulleys including a pulley1521 associated with a rotational motion of the second jaw1502.

In addition, the end tool1500 of the fourth modified example of the fourth embodiment of the present disclosure may include a rotation shaft1541, a rotation shaft1543, and a rotation shaft1544. Here, the rotation shaft1541 may be inserted through an end tool hub1560, and the rotation shaft1543 and the rotation shaft1544 may be inserted through a pitch hub1550. The rotation shaft1541, the rotation shaft1543, and the rotation shaft1544 may be arranged sequentially from a distal end1504 toward a proximal end1505 of the end tool1500.

In addition, the end tool1500 of the fourth modified example of the fourth embodiment of the present disclosure may include the end tool hub1560 and the pitch hub1550.

The rotation shaft1541 is inserted through the end tool hub1560, and the pulley1511 and the pulley1521, which are axially coupled to the rotation shaft1541, and at least some of the first jaw1501 and the second jaw1502 coupled the pulley1511 and the pulley1521 may be accommodated inside the end tool hub1560.

Meanwhile, a first pitch pulley portion1563aand a second pitch pulley portion1563b, which serve as end tool pitch pulleys, may be formed at one end portion of the end tool hub1560. A wire (see303 ofFIG.146) and a wire304 (see304 ofFIG.146) are coupled to the first pitch pulley portion1563aand the second pitch pulley portion1563b, which serve as end tool pitch pulleys, and a pitch motion is performed while the end tool hub1560 rotates around the rotation shaft1543.

The rotation shaft1543 and the rotation shaft1544 may be inserted through the pitch hub1550, and the pitch hub1550 may be axially coupled to the end tool hub1560 by the rotation shaft1543. Accordingly, the end tool hub1560 may be formed to be pitch-rotatable around the rotation shaft1543 with respect to the pitch hub1550.

Meanwhile, the end tool1500 of the fourth modified example of the fourth embodiment of the present disclosure may further include components such as a first electrode1551, a second electrode1552, a guide tube1571, and a blade1575 in order to perform a cauterizing motion and a cutting motion. Here, components related to the driving of the blade, such as the guide tube1571 and the blade1575, may be collectively referred to as a blade assembly. Components for performing a cauterizing motion and a cutting motion in the present embodiment are substantially the same as those described in the fourth embodiment, and thus a detailed description thereof will be omitted herein.

The surgical instrument for electrocautery according to the fourth modified example of the fourth embodiment of the present disclosure may include a wire301, a wire302, a wire303, a wire304, a wire305, a wire306, and a blade wire307, as in the fourth embodiment of the present disclosure described with reference toFIG.140 or the like.

Hereinafter, the actuation hub1590 of the fourth modified example of the fourth embodiment of the present disclosure will be described in more detail.

Referring toFIGS.209 to215, the actuation hub1590 may be formed in the form of a box having a hollow therein. Here, a first coupling hole1590ais formed in any one surface of the actuation hub1590, specifically, a surface coming into contact with the first jaw1501, and a second coupling hole1590bmay be formed in the other surface of the actuation hub1590, specifically, a surface coming into contact with the second jaw1502. Here, the first coupling hole1590aand the second coupling hole1590bmay be disposed on the same line in the Z-axis direction.

In addition, the actuation hub1590 is coupled to each of the first jaw1501 and the second jaw1502. In detail, a first actuation rotation shaft1591 is inserted through the first jaw1501 and the first coupling hole1590aof the actuation hub1590, so that the actuation hub1590 and the first jaw1501 are axially coupled. Further, a second actuation rotation shaft1592 is inserted through the second jaw1502 and the second coupling hole1590bof the actuation hub1590, so that the actuation hub1590 and the second jaw1502 are axially coupled.

Meanwhile, as described with reference toFIG.154 or the like, a tube seating portion, a wire through-hole, and a blade accommodation portion are sequentially formed inside the actuation hub1590, and the blade wire307 may pass through the inside of the actuation hub1590 to be connected to the blade1575.

As described above, by providing the actuation hub1590 to which the guide tube1570 is coupled between the first jaw1501 and the second jaw1502, the guide tube1570 may not be curved, or the angle at which the guide tube1570 is curved may be reduced, even when the first jaw1501 or the second jaw1502 rotates around the first rotation shaft1541 or the actuation rotation shaft1545.

In detail, in a case in which the guide tube1570 is directly coupled to the first jaw1501 or the second jaw1502, when the first jaw1501 or the second jaw1502 rotates, one end portion of the guide tube1570 also rotates together with the first jaw1501 or the second jaw1502, causing the guide tube1570 to be curved.

On the other hand, in a case in which the guide tube1570 is coupled to the actuation hub1590, which is independent of the rotation of the jaw1503, as in the present embodiment, even when the first jaw1501 or the second jaw1502 rotates, the guide tube1570 may not be curved, or the angle at which the guide tube1570 is curved may be reduced even when the guide tube1570 is curved.

That is, by changing the direct connection between the guide tube1570 and the jaw1503 by the actuation hub1590 to an indirect connection, the degree to which the guide tube1570 is curved by the rotation of the jaw1503 may be reduced.

As such, the present disclosure has been described with reference to the embodiments described with reference to the drawings, but it will be understood that this is merely exemplary, and those of ordinary skill in the art will understand that various modifications and variations of the embodiments are possible therefrom. Accordingly, the true technical protection scope of the present disclosure should be defined by the technical spirit of the appended claims.

INDUSTRIAL APPLICABILITY

The present invention relates to a surgical instrument. More specifically, the surgical instrument can be operated manually or automatically for use in laparoscopic surgery or various other surgeries, including a locking device capable of locking and/or unlocking for at least one operation.

Claims (13)

The invention claimed is:

1. An end tool of a surgical instrument, the end tool comprising:

a first jaw and a second jaw configured to be rotatable independently of each other;

a first jaw pulley connected to the first jaw and formed to be rotatable around a first rotation shaft;

a second jaw pulley connected to the second jaw, formed to be rotatable around the first rotation shaft, and formed to be spaced a predetermined distance from the first jaw pulley;

a blade assembly configured to receive a driving force and linearly move between a proximal end and a distal end of the first jaw, and having at least a part formed between the first jaw pulley and the second jaw pulley, the blade assembly including a blade and a guide tube;

a blade wire at least partially in contact with the blade assembly and configured to transfer the driving force to the blade assembly and allow the blade to linearly move in a longitudinal direction; and

an end tool hub including a first jaw pulley coupling portion, a second jaw pulley coupling portion, and a guide portion configured to connect the first jaw pulley coupling portion and the second jaw pulley coupling portion, the first jaw pulley coupling portion and the second jaw pulley coupling portion disposed to face each other,

wherein the first jaw pulley and the second jaw pulley perform a yaw motion while rotating around the first rotation shaft, and the first jaw and the second jaw perform an actuation motion while rotating around an actuation rotation shaft spaced apart by a predetermined distance from the first rotation shaft,

wherein the guide tube is configured to internally accommodate at least a part of the blade wire and is disposed to be bent to a predetermined degree, and

wherein the first jaw pulley is disposed adjacent to the first jaw pulley coupling portion of the end tool hub and the second jaw pulley is disposed adjacent to the second jaw pulley coupling portion of the end tool hub, and at least a part of the blade assembly is disposed between the first jaw pulley and the second jaw pulley.

2. The end tool ofclaim 1, wherein the blade wire passes through an inside of the guide tube and is connected to the blade.

3. The end tool ofclaim 1, wherein when the guide tube is bent to the predetermined degree, the blade wire inside the guide tube is also bent together with the guide tube.

4. The end tool ofclaim 1, wherein the blade wire is formed to be movable along the guide tube in the guide tube.

5. The end tool ofclaim 1, wherein the guide tube is formed to extend toward the blade by passing between central axes of rotation of the first jaw pulley and the second jaw pulley.

6. The end tool ofclaim 1, wherein the guide tube is formed to extend toward the first jaw or the second jaw by passing through the end tool hub.

7. The end tool ofclaim 6, wherein a round portion having a predetermined curvature and rounded outward is formed on an inner circumferential surface of the end tool hub, the inner circumferential surface facing the guide tube passing through the end tool hub.

8. The end tool ofclaim 1, wherein, when the first jaw pulley and the second jaw pulley rotate in a same direction around the first rotation shaft, a yaw motion in which the first jaw and the second jaw rotate in a same direction is performed.

9. The end tool ofclaim 1, wherein, when the second jaw pulley rotates around the first rotation shaft relative to the first jaw pulley, an actuation motion in which the second jaw rotates relative to the first jaw is performed.

10. The end tool ofclaim 1, comprising:

a pair of end tool first jaw pitch main pulleys formed at one side of the first jaw pulley, and formed to be rotatable around a third rotation shaft forming a predetermined angle with the first rotation shaft; and

a pair of end tool second jaw pitch main pulleys formed on one side of the second jaw pulley and formed to be rotatable around the third rotation shaft.

11. The end tool ofclaim 10, wherein the end tool is formed to be yaw-rotatable around the first rotation shaft and simultaneously pitch-rotatable around the third rotation shaft.

12. The end tool ofclaim 10, further comprising:

a first jaw wire at least a part of which is wound around the first jaw pulley and the pair of end tool first jaw pitch main pulleys; and

a second jaw wire at least a part of which is wound around the second jaw pulley and the pair of end tool second jaw pitch main pulleys.

13. The end tool ofclaim 1, wherein the blade is configured to move between the proximal end and the distal end of the end tool by the blade wire.

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